Acute median neuropathy following physeal fractures of the distal radius

Displaced distal physeal fractures of the radius are at risk for development of median neuropathy. The mechanism of injury includes compression of the nerve by the displaced fracture, contusion of the nerve at the time of fracture or reduction, or the development of a compartment syndrome. Patients with significant soft-tissue swelling and symptoms or signs of median nerve dysfunction are especially at risk for worsening neuropathy after closed reduction and closely applied cast immobilization or after open reduction. Closed reduction and percutaneous pin fixation may be the optimal treatment for these patients.