Case: A 30-year-old man sustained an injury to the right elbow after a fall from a bike. On clinical examination, he had preoperative radial nerve palsy with radiological diagnosis of the intercondylar distal humerus fracture. Intraoperatively, the patient had the radial nerve entrapped between the proximal metaphyseal fragment and distal lateral condyle of the humerus.
Conclusion: Preoperative radial nerve palsy associated with the intercondylar distal humerus fracture is very rare. Fractures with the significant anterolateral displacement of the proximal metaphyseal fracture segment may entrap the course of the radial nerve in the anterior compartment of the distal humerus and thus manifest as radial nerve palsy.