Rehabilitation of a Patient with Post Traumatic Triple Nerve Palsy of the Upper Limb

Post traumatic triple nerve palsy in the upper limb is rare and usually follows the unregulated use of a tourniquet, severe proximal limb injuries and near total amputations. This paper describes a peculiar case of triple nerve palsy following a road traffic accident in which the patient developed a radial nerve palsy complicating a closed humeral fracture and a low median and ulnar nerve palsy in the same limb due to a mid forearm level glass-cut injury. The challenges in rehabilitation included: lack of extensors and intrinsic muscle function initially that made flexor tendon rehabilitation difficult; a wrist drop and finger drop deformity that became more apparent after the flexor tendon rehabilitation; gradual onset of intrinsic minus deformity as the radial nerve spontaneously recovered. The orthotist had to make special splints and the rehabilitation team had to tailor the therapy at every stage of nerve recovery to provide optimal function without the development of contractures.