A patient goes to the ER with a fracture to their elbow from a fall off a ladder. What nerve will most likely be damaged?

In the context of an elbow fracture, the ulnar nerve is often the nerve most likely to be damaged due to its anatomical pathway. The ulnar nerve runs posterior to the medial epicondyle of the humerus, which is the bony prominence at the elbow. Fractures or dislocations around the elbow, especially those that involve trauma to the medial aspect, can easily result in injury to the ulnar nerve.

When assessing potential nerve damage in a case of an elbow injury, it’s important to consider the common mechanisms of injury and the location of the nerves relative to the elbow joint. The ulnar nerve is particularly vulnerable because it is not protected by muscle and lies close to the surface as it passes around the medial epicondyle.

Other nerves listed do have involvement in elbow injuries, but they are typically less affected. The median nerve primarily travels along the anterior aspect of the forearm and wrist, while the radial nerve runs on the posterior side of the arm and can be affected in humeral shaft fractures due to its location. The axillary nerve, which innervates the deltoid and teres minor muscles, typically would not be involved unless there is a shoulder dislocation or humeral neck fracture