Priority 19 from the Broken Bones of the Upper Limb in People over 50

UNCERTAINTY: What is the best way to treat a nerve injury that happens at the same time as an upper limb fracture in people over 50? (JLA PSP Priority 19)
Overall ranking 19
JLA question ID 0093/19
Explanatory note When a patient breaks their arm, there is a chance that they can injure their nerves as well. Although the incidence of nerve injuries is low, they can cause significant long-term problems for the patient. It is important to spot these injuries early. This question looks to determine the best way to assess for an injured nerve and what is the best way to treat it, if it does occur.
Evidence

Processed nerve allografts to repair peripheral nerve discontinuities. Interventional procedures guidance [IPG597] Published date: November 2017

Alaqeel A, Alshomer F. High resolution ultrasound in the evaluation and management of traumatic peripheral nerve injuries: review of the literature. Oman Med J. 2014;29(5):314–319. doi:10.5001/omj.2014.86

Health Research Classification System category Injuries and Accidents
Extra information provided by this PSP
Original uncertainty examples Is this stage too early to be assessing for associated nerve damage? ~ If the fracture is reduced, should there be an MRI / USS routinely to ensure no nerve damage at the time? ~ Can this have an impact on nerve function and rehab later down the line?
Submitted by 13 x Healthcare Professionals, 1 x patient
PSP information
PSP unique ID 0093
PSP name Broken Bones of the Upper Limb in People over 50 PSP
Total number of uncertainties identified by this PSP. 50 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 3 December 2018