Case Study
Mid-shaft Humeral Fracture

A 27 year old male was a passenger in an automobile when the car was hit on the passenger's side by a speeding car passing a red light.  The impact occurred directly on the passengers right arm.  He was removed from the automobile and transported to the hospital.  His right upper limb had a spreading hematoma on the lateral surface of the arm and x-ray confirmed a clean mid-shaft fracture of the humerus.  Over the course of the next several hours, the patient experienced a progressive weakness in extension of his right elbow, and it was  noted that he was unable to extend his wrist.  He could still flex his elbow on command, though weakly in comparison to normal.  He could still supinate and pronate his forearm.  



Questions to be answered:

1. Do you suspect that nerve damage has occurred? If so, what nerve(s) were injured?

     
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2. Why was the patient unable to extend his wrist?

     
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3. What accounts for the weakness in elbow flexion?

     
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4. Why are supination and pronation intact?

     
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5. What, if any, sensory defects might this patient be experiencing?

     
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