Median Nerve Displacement during Hardware Removal after Distal Radius Fractures

This retrospective study aimed to evaluate median nerve displacement observed during hardware removal procedures following volar plating for distal radius fractures.

We reviewed all cases involving removal of distal radial volar locking plates at our institution by two surgeons from 2016 to 2021. Plating procedures and hardware removals were performed using the flexor carpi radialis (FCR) approach. We examined the position of the median nerve at the time of hardware removal.

Median nerve displacement to the radial side of the FCR occurred in 17 out of 67 cases (25%). There were no significant differences in the degree of fracture severity or involved surgeons between the normal position and displaced groups.

The median nerve may be displaced radially from the FCR during hardware removal, and care should be taken to avoid causing iatrogenic nerve injury.

Level II.