Peripheral nerve injuries: radial nerve: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Peripheral nerve injuries: radial nerve

Sample item

A man with a closed fracture of the humeral shaft at the junction of the middle and distal thirds has wrist drop and loss of sensation over the first dorsal web space. The skin is intact. What is the best management of the nerve?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Splint the wrist and fingers and observe for recovery

Radial palsy with a closed humeral shaft fracture is usually neurapraxia and recovers over about 3 months. Splint the wrist, keep joints supple, and explore only if there is no recovery on follow-up.

Option by option

  • A. Splint the wrist and fingers and observe for recovery (correct)

    Correct. Expect neurapraxia, and observe with a splint.

  • B. Immediate tendon transfers

    Tendon transfers are for permanent palsy and not done at the start.

  • C. Perineural steroid injection

    Steroid injection does not hasten recovery of a neurapraxia.

  • D. Immediate nerve exploration and grafting

    Early exploration is unnecessary in a closed fracture with a likely neurapraxia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, Splint the wrist and fingers and observe for recovery. Radial palsy with a closed humeral shaft fracture is usually neurapraxia and recovers over about 3 months.

Why is "Immediate tendon transfers" not the answer?

Tendon transfers are for permanent palsy and not done at the start.

Why is "Perineural steroid injection" not the answer?

Steroid injection does not hasten recovery of a neurapraxia.

Why is "Immediate nerve exploration and grafting" not the answer?

Early exploration is unnecessary in a closed fracture with a likely neurapraxia.

What concept does this question test?

It tests Peripheral nerve injuries: radial nerve in Orthopaedics. Splint the wrist, keep joints supple, and explore only if there is no recovery on follow-up.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Peripheral nerve injuries: radial nerve?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.