David Nelson , MD
Private Practice, San Francisco
Webmaster, eRadius
Associate Editor, J Hand Surgery
Director, San Francisco Bay Area Hand Club

The fracture alignment after the external fixation by the referring physician.
(PA showing the fixator at top, PA, oblique, and lateral below.)

The patient had a reduction of the open-book pelvis fracture with an anterior pubic plate and an I&D with external fixation of the distal radius, all at a single time. The median nerve was not released. Blood pressure is under control, there is no problem from the head injury.

The status of the median nerve on admission was never documented clearly, due to the altered level of consciousness and the need to rapidly move to the OR to stabilize his pelvic fracture and life-threatening hypotension.

Postoperatively, the patient began to complain of median nerve numbness.

(5) What is your assessment of this reduction? Can you accept this reduction?

(6) What are your options now?

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