Aster Cedars Hospital & Clinic, Jebel Ali has successfully treated a young patient with a rare and serious arm injury (a comminuted humerus fracture with radial nerve palsy), restoring full movement and strength through timely surgical intervention and coordinated specialist care.
In August 2025, 22-year-old Indian construction worker Mr. Mohammed Saifuddin Abdul Salam was rushed to the Emergency Department at Aster Cedars Hospital & Clinic, Jebel Ali after sustaining a fall from a staircase at his workplace. He presented with severe pain, swelling and visible deformity of the right upper arm, along with an alarming inability to lift his wrist and fingers, a clinical condition commonly referred to as wrist drop.
Scans confirmed that the lower part of the right upper arm bone had broken into several pieces Clinical examination also showed a nerve injury affecting the arm and hand (high radial nerve palsy), a serious complication that could cause permanent disability if not treated promptly.
Radial nerve palsy is the most common nerve injury that can happen after a humerus fracture, occurring in about 2 to 17 per cent of cases.1 But the type of fracture in this patient was quite rare. Fractures of the upper arm bone (humeral shaft fractures) make up only about 1 to 5 per cent of all bone fractures[1], and the Holstein–Lewis type accounts for just 7 to 7.5 per cent of these.2 This combination of injuries made the case both uncommon and high risk.
The injury was a Holstein–Lewis fracture, a spiral break in the lower part of the upper arm where the radial nerve passes through a narrow space, making it vulnerable to being pinched or trapped. In this case, the bone was shattered into multiple pieces, causing sudden wrist drop and greatly increasing the risk of nerve damage and long-term loss of arm function, particularly in severe workplace accidents common in the UAE.
Recognising the urgency and complexity of the condition, the case was managed under the care of Dr. Shafeed Thadathil Parambil, Specialist Orthopaedic Surgeon at Aster Cedars Hospital & Clinic, Jebel Ali.
“Holstein–Lewis fractures are especially demanding because the radial nerve is highly vulnerable at this location,” said Dr. Shafeed Thadathil Parambil, Specialist Orthopaedic Surgeon at Aster Cedars Hospital & Clinic, Jebel Ali. “Without timely surgery, a trapped or irritated nerve can lead to permanent wrist drop, muscle wasting and loss of hand sensation. Early surgical intervention within the golden window of 24 to 72 hours allows us to directly visualise, protect and decompress the nerve while stabilising the fracture, significantly improving the chances of full functional recovery.”
The patient underwent Open Reduction and Internal Fixation (ORIF) on 5 August 2025 at Aster Cedars Hospital & Clinic, Jebel Ali. Through a posterior approach, surgeons stabilised the fracture, confirmed the radial nerve was intact but bruised, and secured the bone with plates and screws. Intraoperative X-rays confirmed correct alignment, and an above-elbow splint was applied postoperatively for protection.
The complex procedure required advanced trauma expertise and meticulous nerve preservation. The patient tolerated the surgery well and recovered in stable condition. Early assessment indicated neurapraxia, a temporary nerve injury, with surgical decompression supporting nerve recovery.
Since the patient still had some nerve symptoms after surgery, he was further checked by Dr. Rajshekher Garikapati, Neurologist at Aster Hospital, Mankhool. Detailed nerve tests were done on both arms to assess the nerve and guide the recovery plan, helping the doctors monitor healing and adjust rehabilitation.
Physiotherapy, led by Ms. Shruthi Janardhan Prabhu, Physiotherapist at Aster Cedars Hospital & Clinic, Jebel Ali, was central to the patient’s recovery. The programme focused on pain management, nerve-gliding exercises, muscle strengthening, and retraining wrist and hand movements. Within three to four weeks, the patient showed initial movement and progressed to full elbow and wrist range of motion, with grip strength reaching approximately 90% of the unaffected hand.
By October 2025, follow-up checks confirmed full recovery of the radial nerve, normal movement of the hand and wrist, a healed surgical incision, and a stable bone repair. The patient was able to return to daily activities and was cleared to resume work, with instructions to avoid heavy lifting for six months.
Expressing his gratitude, the patient, Mr. Mohammed Saifuddin said, “When I couldn’t move my hand, I was very scared about my future and my job. The doctors and therapists at Aster never gave up on me. Dr. Shafeed explained everything clearly and treated me like family. Today, I can use my hand normally again, and I am deeply thankful to the entire team for giving me my life back.”
This successful outcome highlights Aster Cedars Hospital & Clinic, Jebel Ali’s capability in managing complex orthopaedic trauma through early diagnosis, meticulous nerve-preserving surgery, specialist neurological evaluation, structured physiotherapy rehabilitation and compassionate, patient-centred follow-up care.
