From car crashes to kitchen accidents, there are many common causes of nerve damage and injury. However, an unexpected cause of nerve damage stems from another type of injury: a bone fracture.
Fractures occur when a bone breaks or splinters due to trauma, overuse or particular diseases that may weaken bones. Much like our skeletal system, the peripheral nerve system runs throughout our body and helps us to function and feel. When one or both systems are damaged, it can be very painful.
when a fracture is more than a fracture
When a bone fractures, there is also risk of damaging the surrounding nerves. In the table below, you can see a collection of common fractures and the corresponding nerves that are at risk of injury, along with signs that nerve damage may have occurred:
| fractures or dislocations | commonly impacted nerves | clinical signs of damage |
| shoulder fracture and/or dislocation |
axillary nerve | loss of deltoid contraction (shoulder weakness) numbness over top of the upper arm |
| humerus (arm) fracture | radial nerve | wrist drop numbness over the back of hand |
| supracondylar (elbow) fracture in children |
median nerve (anterior interrosseous nerve) |
loss of thumb and index finger flexion Inability to make an “OK” sign |
| forearm fracture | posterior interrosseous nerve | fingers and thumb drop (at the knuckles) deviated wrist extension |
| hip dislocation | sciatic nerve (cpn component) |
foot drop numbness over the back of foot |
| knee dislocation | common peroneal nerve | foot drop numbness over the back of foot |
Source: https://nerveclinic.co.uk/nerve-injuries/nerve-injury-after-fracture-or-dislocation
fractures don’t discriminate
There are two types of fractures: open and closed.
A closed fracture does not break the skin, whereas an open fracture does. Both types can lead to nerve damage.
Closed fractures “may be complicated by associated peripheral nerve injury. However, because clinical information is limited, determining the best course of treatment is difficult,” according to one study published in the Journal of the American Academy of Orthopaedic Surgeons.
The study also found that people with open fractures can experience complications with peripheral nerve injuries. Patients who haven’t fully recovered function or feeling after 3 months should talk to their doctor about the potential of nerve damage.
When either kind of fracture is repaired and the course of action around the nerves is uncertain, the nerves are often left to try to heal on their own. Nerve injuries can also occur during surgery to fix fractures, such as when using pins to hold broken pieces together.
what this means for nerves
When doctors are focused on setting bones, stitching wounds and tending to other traumatic injuries, it’s not always possible to give attention to the more minute details that come with preserving nerve function. Nerve repair is a very niche and complicated area of expertise, and not every surgeon is fully trained on its nuances. So while your ER doctor is focused on your immediate or acute injury, a surgeon who specializes in microsurgery will have more in-depth training to perform nerve surgery.
Without proper treatment, nerves might not heal properly on their own. They could remain compressed, stretched or severed. Damaged nerves can lead to neuromas (a tangle of nerve and scar tissue) as they try to heal themselves.
When this happens, pain caused by nerve damage can linger long after the bone is set and healed. But just because that pain lingers, doesn’t mean there’s no solution for relieving that pain.
what this means for you
Lasting nerve pain doesn’t have to be your normal. Nerve repair surgery is possible.
Depending on the type of damage, a surgeon can repair the nerve by either reconnecting the nerve to allow the restoration of normal signals to the brain, isolating the nerve end to stop it from growing, or rerouting the nerves.
If you think you have nerve injuries and pain resulting from a fracture, nerve repair surgery might be the right choice for you.