Background: A 55 year old gentleman presented with tardy posterior interosseous nerve palsy associated with radial head fracture.
Case presentation: The patient developed symptoms of wrist drop 24 hours after the injury whilst awaiting surgery for his Mason III radial head fracture. EMG studies confirmed the presence of a posterior interosseous nerve lesion. Open exploration revealed oedematous soft tissues surrounding the nerve. The proximity of the nerve to the fracture and its course through the arcade of Frohse make it susceptible to injury, from the initial traumatic event and the following oedema.
Conclusion: A full recovery occurred after exploration and decompression of the nerve.