Radial Nerve Palsy following Endovascular Embolization of an Arteriovenous Malformation

Background Arteriovenous malformations (AVMs) are commonly treated using endovascular techniques. Previous nerve palsies after embolization have been reported as isolated case reports, none of which affected the forearm. Case Description A case of acute, transient neuropathy of the radial nerve following embolization of a forearm AVM is described. The patient, an otherwise healthy 27-year-old man, began having symptoms of superficial radial nerve (SRN) and posterior interosseous nerve (PIN) palsies immediately following endovascular embolization. He underwent decompression of the radial nerve within 5 days and was found to have direct compression of the PIN and SRN. The patient recovered completely at the time of his 7-month follow-up. Literature Review Few cases of nerve palsy after endovascular embolization have been reported in the literature. Many are intracranial, but rare instances of peripheral nerve palsy have been reported, including two sciatic nerve and four digital nerve palsies after endovascular embolization. No cases of peripheral nerve palsy in the forearm have been reported. Clinical Relevance We recommend careful consideration of surrounding neural elements at risk for palsy prior to endovascular embolization and detailed discussion with the patient during the informed consent process.

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Irreparable Radial Nerve Palsy Due to Delayed Diagnostic Management of a Giant Lipoma at the Proximal Forearm Resulting in a Triple Tendon Transfer Procedure: Case report and Brief Review of Literature

The Open Orthopaedics Journal ◽

10.2174/1874325001711010794 ◽

2017 ◽

Vol 11 (1) ◽

pp. 794-803 ◽

Cited By ~ 2

Author(s):

Ingo Schmidt

Keyword(s):

Functional Recovery ◽

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Patient Reported ◽

Diagnostic Management ◽

Giant Lipoma ◽

Proximal Forearm

Background: Non-traumatic radial nerve palsy (RNP) caused by local tumors is a rare and uncommon entity. Methods: A 62-year-old female presented with a left non-traumatic RNP, initially starting with weakness only. It was caused by a benign giant lipoma at the proximal forearm that was misdiagnosed over a period of 2 years. The slowly growth of the tumor led to an irreparable overstretching-related partial nerve disruption. For functional recovery of the patient, a triple tendon transfer procedure had to be performed. Results: Four months after surgery, the patient was completely able to perform her activities of daily living again. At the 10-months follow-up, strength of wrist extension, thumb's extension and abduction, and long fingers II-V extension had all improved to grade 4 in Medical Research Council scale (0-5). In order to restore motion, the patient reported that she would undergo the same triple tendon transfer procedure a second time where necessary. Due to the initially misdiagnosed tumor, there was an overall delayed duration of time for functional recovery of the patient. Conclusion: The triple tendon transfer procedure offers a useful and reliable method to restore functionality for patients sustaining irreparable RNP. However, it must be noted critically with our patient that this procedure probably would have been avoided. Initially, there was weakness only by entrapment of the radial nerve. RNP caused by local tumors are uncommon but known from the literature, and so it should be considered generally in differential diagnosis of non-traumatic RNP.

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Retrospective case series with one year follow-up after radial nerve palsy associated with humeral fractures

International Orthopaedics ◽

10.1007/s00264-016-3186-3 ◽

2016 ◽

Vol 41 (1) ◽

pp. 191-196 ◽

Cited By ~ 5

Author(s):

Nikolaus Wilhelm Lang ◽

Roman Christian Ostermann ◽

Cathrin Arthold ◽

Julian Joestl ◽

Patrick Platzer

Keyword(s):

Radial Nerve ◽

Nerve Palsy ◽

Case Series ◽

Humeral Fractures ◽

Radial Nerve Palsy ◽

Retrospective Case ◽

Retrospective Case Series ◽

One Year

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Tendon transfer for radial nerve palsy: a single tendon to restore finger extension as well as thumb extension/radial abduction

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412437509 ◽

2012 ◽

Vol 37 (9) ◽

pp. 855-862 ◽

Cited By ~ 4

Author(s):

M. M. Al-Qattan

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Wrist Movement ◽

Pronator Teres ◽

Finger Extension ◽

A Prospective Study ◽

Extensor Carpi Radialis

Since 1994, the author has been treating irreparable radial nerve palsy with pronator teres to the extensor carpi radialis brevis (for wrist extension) and a single tendon (flexor carpi radialis or ulnaris) transfer to restore finger extension as well as thumb extension/radial abduction. We sought to investigate whether these patients are able to flex the fingers with the thumb in abduction/extension posture. This was a prospective study over a 5-year period, and the results of this transfer in 15 consecutive patients (mean age 28 years) were analyzed. At final follow-up (mean 30 months), all patients had reasonable wrist movement, finger extension, and thumb extension/radial abduction. The overall results were rated excellent in 12 patients and good in the remaining three patients according to the Bincaz scale. More interesting was the ability of all patients to flex their fingers with only mild relaxation of the extended/abducted thumb.

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Tendon transfers in radial nerve palsy with fractures of the humerus: Case reports

East African Orthopaedic Journal ◽

10.4314/eaoj.v4i1.63616 ◽

2011 ◽

Vol 4 (1) ◽

Author(s):

GK Museve

Keyword(s):

Radial Nerve ◽

Nerve Palsy ◽

Case Reports ◽

Radial Nerve Palsy ◽

Tendon Transfers

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Tendon Transfers in Upper Extremity Reconstruction

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0101 ◽

2019 ◽

pp. 1015-1018

Author(s):

Vincent G. Laurence ◽

Gregory Rafijah

Keyword(s):

Peripheral Nerve ◽

Upper Extremity ◽

Nerve Injury ◽

Radial Nerve ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Tendon Transfers ◽

History Of ◽

Extremity Reconstruction ◽

Radial Nerve Injury

Tendon transfers, first performed more than 100 years ago, remain one of the most powerful tools in the hand surgeon’s repertoire for addressing chronic peripheral nerve palsies. Dozens of transfers have been described in the intervening years, but three sets of transfers to provide wrist, finger, and thumb extension after a high radial nerve injury remain among the most commonly performed. This chapter briefly discusses the history of tendon transfers; outlines the general principles, indications, and timing of transfers; and provides a detailed, step-by-step description of the authors’ preferred set of transfers (the FCR set) for a high radial nerve palsy.

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A case of malignant peripheral nerve sheath tumor(MPNST) which was treated with total resection followed by successful tendon transfers for radial nerve palsy.

Skin Cancer ◽

10.5227/skincancer.16.319 ◽

2001 ◽

Vol 16 (3) ◽

pp. 319-323 ◽

Cited By ~ 1

Author(s):

Hiroto TERASHI ◽

Yuki MATSUO ◽

Naoko TAKEO ◽

Hideyuki TADA ◽

Yuji ASADA ◽

...

Keyword(s):

Peripheral Nerve ◽

Radial Nerve ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Nerve Sheath Tumor ◽

Total Resection ◽

Tendon Transfers ◽

Peripheral Nerve Sheath Tumor ◽

Nerve Sheath

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Radial Nerve Palsy: Nerve Transfer Versus Tendon Transfer to Restore Function

Hand ◽

10.1177/1558944720988126 ◽

2021 ◽

pp. 155894472098812

Author(s):

J. Megan M. Patterson ◽

Stephanie A. Russo ◽

Madi El-Haj ◽

Christine B. Novak ◽

Susan E. Mackinnon

Keyword(s):

Radial Nerve ◽

Tendon Transfer ◽

Nerve Palsy ◽

Nerve Transfer ◽

Pinch Strength ◽

Radial Nerve Palsy ◽

Nerve Injuries ◽

Tendon Transfers ◽

Nerve Transfers ◽

Transfer Group

Background: Radial nerve injuries cause profound disability, and a variety of reconstruction options exist. This study aimed to compare outcomes of tendon transfers versus nerve transfers for the management of isolated radial nerve injuries. Methods: A retrospective chart review of 30 patients with isolated radial nerve injuries treated with tendon transfers and 16 patients managed with nerve transfers was performed. Fifteen of the 16 patients treated with nerve transfer had concomitant pronator teres to extensor carpi radialis brevis tendon transfer for wrist extension. Preoperative and postoperative strength data, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, and quality-of-life (QOL) scores were compared before and after surgery and compared between groups. Results: For the nerve transfer group, patients were significantly younger, time from injury to surgery was significantly shorter, and follow-up time was significantly longer. Both groups demonstrated significant improvements in grip and pinch strength after surgery. Postoperative grip strength was significantly higher in the nerve transfer group. Postoperative pinch strength did not differ between groups. Similarly, both groups showed an improvement in DASH and QOL scores after surgery with no significant differences between the 2 groups. Conclusions: The nerve transfer group demonstrated greater grip strength, but both groups had improved pain, function, and satisfaction postoperatively. Patients who present early and can tolerate longer time to functional recovery would be optimal candidates for nerve transfers. Both tendon transfers and nerve transfers are good options for patients with radial nerve palsy.

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