Median Nerve Allograft

History/Diagnosis: This patient is a 35 year old gentlement who sustained a glass puncture injury to his forearm about 3 weeks before presenting to my office for evaluation.  He initially did not think the injury was severe, but due to continued pain and numbness was concerned that it may be more involved.  His exam was consistent with numbness in the median nerve distribution and a laceration suggesting a median nerve injury. I recommended exploration and allograft repair. 

Treatment: Intra-operatively he was found to have a completed laceration of the median nerve.  I resected the nerve to healthy tissue and performed an allograft repair with suture and fibrin glue.


Outcome: He did very well during his recovery.  He recovered nearly 100% of his finger motion.  His sensation improved every visit and by 6 months he had sensation and tingling into the tips of his thumb, index, and middle fingers. 


Complex Motorcycle Accident

History/Diagnosis: This patient sustained a very severe motorcycle accident with open injuries to the forearm, wrist, hand, and fingers.  There were fractures of the ulna, radius, ulnar styloid, thumb dislocation, metacarpals, and CMC joints.  I took her to the operative room for extensive surgery to repair and reconstruct all of the injuries.  

Treatment: Complex repair of all injuries.

Outcome: She did exceptionally well, essentially regaining full function and strength.  She returned to riding motorcycles, returned to work, and was very pleased!


Radius Shaft Fracture ORIF

History/Diagnosis: This gentleman sustained an isolated radial shaft fracture. 

Treatment: Radial shaft ORIF

Outcome: He regained full motion and strength without any limitations


Bilateral Forearm ORIF

History: 22 year-old male injured in a motorcycle accident with bilateral forearm fractures of the radius and ulna.  

Diagnosis: Complex bilateral forearm fractures with comminution, open injuries, and need for repair


Treatment: Bilateral forearm ORIF


Outcome: Within 6 weeks he had near full motion. He had minimal pain and was quite pleased with the final result. 

Segmental Galeazzi

History: 24 year old gentleman presented to the hospital after crashing his motorcycle.  He had obvious deformities to his right forearm and wrist.  I evaluated him and recommended surgery for his complex radial shaft and DRUJ injuries. Intra-operatively he was found to have multiple shaft fractures, further complicating the surgery. 

Diagnosis: Right wrist and forearm Galeazzi fracture

Treatment: Intra-operative findings necessitated and combination of pins and plate extensions in addition to standard volar plating and screws to capture multiple fracture components.  The sequence of fixation is shown here. 

Outcome: He did very well in the early post-operative period, making improvements in his wrist motion and forearm supination.  By 1 month he had already regained 30% of wrist motion and 50% of forearm supination.  He had very little pain and was slowly returning to activity. 

Open Galeazzi – Franko

History: 58 year old male was hit by a vehicle and presented to the hospital with obvious open deformities of his right forearm and wrist.  He was diagnosed with an open radial shaft fracture and instability of the distal radioulnar joint. 

Diagnosis: Right open Galeazzi fracture

Treatment: Open reduction, internal fixation of the radius with a combination of plates and screws

Outcome: By 3 months after surgery he was healing exceptionally well.  He had very good wrist motion of greater than 70 degree arc, near full supination and pronation, and no pain. 

Radius/Ulna ORIF

History: 25 year old male injured his left forearm and fractured (broke) his radius and ulna. He was splinted in the emergency department and presented to my office for further evaluation. His job includes very heavy lifting and his priority was to return to work as soon as possible.

Diagnosis: Left radius and ulna shaft fractures

Treatment: Left radius and ulna open reduction internal fixation

Outcome: Within 2 weeks he was already using his forearm naturally. He tried returning to work by 4 weeks and was able to left up to 25 pounds against my advice. He continued to get stronger and by 8 weeks was already lifting over 100 pounds. He went on to heal the fractures by 3 months without any pain or limitation.

Bilateral Galeazzi ORIF

History: 21 year old male presented as a trauma patient after a motorcycle accident with injuries to his bilateral forearms.  He was found to have a fracture radius on both side with a ligament injury at the wrist.  He was initially splinted with recommendations for surgery. 

Diagnosis: Bilateral radial shaft (Galeazzi) fractures

Treatment: Bilateral radial shaft ORIF

Outcome: At his first post-operative visit he was doing exceptionally well.  He had nearly full forearm range of motion, minimal pain, and was already doing his normal activities. He was eager to return to the gym but needed to wait at least 6 weeks for the bone to start healing.