• Luis Trigo, Juan Sarasquete, Laura Noguera, Ignacio Proubasta, and Claudia Lamas.
• Orthopaedic Department, Servicio Cirugía Ortopédica, Hospital Santa Cruz y San Pablo, Barcelona Autonoma University, Barcelona, Spain.
• Arch Orthop Trauma Surg. 2017 Jul 1; 137 (7): 953957953-957.

IntroductionRadial nerve palsy is a rare but serious complication following elbow external fixation. Only 11 cases have been reported in the literature to date, but the incidence may be underreported. We present three new cases of this complication.Materials And MethodsWe analyzed the three cases of radial palsy seen in our center following the application of an external fixator as treatment for complex elbow injuries.ResultsMean patient age at surgery was 50 years. Two patients were female and one was male. In the three cases, the initial lesion was a posterior elbow dislocation, associated with a fracture of the radial shaft in one and a radial head fracture and coronoid fracture, respectively, in the other two. Due to persistent elbow instability, an external fixator was applied in all three cases. The fixator pins were introduced percutaneously in two cases and under direct vision in an open manner in the third case. Radial palsy was noted immediately postoperatively in all cases. It was permanent in two cases and temporary in the third.ConclusionRadial nerve palsy after placement of an external elbow fixator was resolved in only 1 of our 3 cases and in 6 of the 11 cases in the literature to date. Although the event is rare, these alarming results highlight the need for recommendations to avoid this complication.

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