RADIAL NERVE INJURIES;

Objective: To highlight etiological factors leading to radial nerve injury resulting in wrist drop, withparticular reference to iatrogenic causes. Design: Retrospection & Descriptive. Material & Methods: One hundredpatients of all ages and both sexes with wrist drop. Data of clinical assessment after detailed history and examinationas well as electro diagnostic studies was recorded on pre-designed assessment proforma. The outcome was charteddown for frequency of etiology of the wrist drop. Setting: Rehabilitation Medicine Department of Combined MilitaryHospital (CMH) Multan and Armed Forces Institute of Rehabilitation Medicine (AFIRM). Results: The major cause ofinjury was splinter/gun shot injury 31%, mis-placed injection at mid-arm 21%fracture of humerus was 21%, compressionneuropathy 16%, and stab wound 11%caused wrist drop. Electro-physiological studies revealed that 85% patients hadinjury to radial nerve at mid-arm, 9% had injury to posterior interosseous nerve while 4% had injury to superficial branchof radial nerve and only 2% had normal study. Electrodiagnostic studies also revealed that majority of the patientssuffered from axonotmesis (44%) and neurapraxia (38%), whereas (16%) were neurotmesis. Conclusion: The mostcommon cause of radial nerve injury is trauma. It is also found that the frequency of radial nerve palsy due to iatrogeniccauses is quite high. In addition to the clinical examination, the nerve conduction studies and electromyography provedto be the better investigation technique in the assessment of the location, severity and extent of the peripheral nerveinjury and subsequently guides in starting the proper treatment option due to early referral of patient to the concernedfields.

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Iatrogenic Radial Nerve Palsy following Closed Reduction of a Simple Diaphyseal Humeral Fracture: Beware the Perfect X-Ray

Case Reports in Emergency Medicine ◽

10.1155/2016/2636450 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Morgan Jones ◽

Hean Wu Kang ◽

Christopher O’Neill ◽

Paul Maginn

Keyword(s):

Nerve Injury ◽

Clinical Assessment ◽

Radial Nerve ◽

Nerve Palsy ◽

Humeral Fracture ◽

Shaft Fracture ◽

Humeral Shaft Fracture ◽

Radial Nerve Palsy ◽

X Ray ◽

Radial Nerve Injury

Radial nerve injury is a recognised complication associated with humeral shaft fracture. A case of iatrogenic radial nerve injury is presented following fracture reduction. The relevant anatomy, challenges in management of humeral fractures with associated radial nerve injury, and the importance of detailed clinical assessment and documentation are discussed.

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Managing Radial Nerve Injuries Associated with Humeral Fracture

Revista de Chimie ◽

10.37358/rc.20.1.7865 ◽

2020 ◽

Vol 71 (1) ◽

pp. 400-404

Author(s):

Vlad Carbunaru ◽

Ana Maria Oproiu ◽

Adrian Barbilian ◽

Chen Feng-Ifrim ◽

Alexandra Ciotei

Keyword(s):

Nerve Injury ◽

Radial Nerve ◽

Nerve Palsy ◽

Bone Fractures ◽

Humeral Fracture ◽

High Energy ◽

Humeral Shaft ◽

Long Bone ◽

Radial Nerve Palsy ◽

Radial Nerve Injury

The overall prevalence of radial nerve injury after humeral shaft fractures is up to 18% representing the most common peripheral nerve injury associated with long bone fractures. Spiral or oblique fractures of the junction between the middle and distal third of the humeral shaft are at greater risk for radial nerve injury. Iatrogenic damage to the radial nerve may also occur during manipulations of closed reduction. A prospective study between 2017-2019 following 5 patients (all male, with ages between 30 and 56 years old), who were treated at our clinic for complete radial nerve palsy after a high-energy fracture of the humerus. All the patients were followed-up for a mean of 6 months (range 4 - 15 months) post op. The first 3 cases showed the initial signs of recovery 4 weeks after the operation. In the last 2 cases a palliative radial intervention was required. The consequences of the radial nerve palsy associated with humeral fractures is strongly related to trauma mechanism. In high energy fractures, severe contusion or transection of the nerve must be expected. In this case, nerve recovery is unlikely and the patients should be informed of the poor prognosis and the need of 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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Isolated Radial Nerve Palsy as a Complication After Anterior Dislocation of the Glenohumeral Joint: A Case Report and Clinical Review

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709619844289 ◽

2019 ◽

Vol 7 ◽

pp. 232470961984428

Author(s):

Grigorios Kastanis ◽

Petros Kapsetakis ◽

George Velivasakis ◽

Manolis Spyrantis ◽

Anna Pantouvaki

Keyword(s):

Nerve Injury ◽

Radial Nerve ◽

Nerve Palsy ◽

Glenohumeral Joint ◽

Correct Diagnosis ◽

Anterior Dislocation ◽

Radial Nerve Palsy ◽

Left Shoulder ◽

Physiotherapy Program ◽

Wrist Drop

Shoulder dislocation is the most common feature in emergencies, while the anterior dislocation of the glenohumeral joint is the most frequent and requires reduction. Accompanied nerve injury is common with an incidence of 21%, while radial nerve palsy is very rare. We describe the case of a 56-year-old man who presented with an anterior dislocation of the left shoulder due to a fall on an outstretched hand with wrist drop 8 hours after injury. Neurological examination revealed loss of sensation along the radial border of the forearm. Closed reduction with Kocher procedure was performed. Magnetic resonance image demonstrated a rotator cuff tear, and 3 weeks after the injury electromyography showed complete radial nerve palsy. A physiotherapy program was applied to the wrist and fingers with the goal of maintaining a full passive range of motion in all joints affected while shoulder rehabilitation started 6 weeks after his fall. Isolated radial nerve palsy associated with an anterior dislocation of the shoulder is very rare but not impossible to occur. Correct diagnosis of the nerve injury associated with the anterior dislocation is very important because it has serious implications on the management and activity morbidity.

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Intraoperative radial nerve injury during coronary artery surgery – report of two cases

Journal of Brachial Plexus and Peripheral Nerve Injury ◽

10.1186/1749-7221-1-7 ◽

2014 ◽

Vol 01 (01) ◽

pp. e44-e47 ◽

Cited By ~ 1

Author(s):

Marianna Papadopoulou ◽

Konstantinos Spengos ◽

Apostolos Papapostolou ◽

Georgios Tsivgoulis ◽

Nikolaos Karandreas

Keyword(s):

Coronary Artery ◽

Nerve Injury ◽

Radial Nerve ◽

Coronary Artery Surgery ◽

Radial Nerve Injury

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The below elbow cast: a cause of median and radial nerve injury after coronary bypass surgery

Injury ◽

10.1016/s0020-1383(00)00106-6 ◽

2001 ◽

Vol 32 (1) ◽

pp. 78-79

Author(s):

J.J Candal-Couto ◽

A McCaskie ◽

P.J Briggs ◽

S Ledingham

Keyword(s):

Nerve Injury ◽

Radial Nerve ◽

Bypass Surgery ◽

Coronary Bypass ◽

Coronary Bypass Surgery ◽

Radial Nerve Injury

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Radial Nerve Injury During Double Plating of a Displaced Intercondylar Fracture

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2012.01.002 ◽

2012 ◽

Vol 37 (4) ◽

pp. 669-672 ◽

Cited By ~ 12

Author(s):

Rebecca Lim ◽

Shian Chao Tay ◽

Andrew Yam

Keyword(s):

Nerve Injury ◽

Radial Nerve ◽

Radial Nerve Injury ◽

Double Plating

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Synkinetic wrist extension in distinguishing cortical hand from radial nerve palsy

Practical Neurology ◽

10.1136/practneurol-2018-001971 ◽

2018 ◽

Vol 18 (6) ◽

pp. 520-521 ◽

Cited By ~ 3

Author(s):

Francesco Brigo ◽

Giammario Ragnedda ◽

Piera Canu ◽

Raffaele Nardone

Keyword(s):

Ischaemic Stroke ◽

Acute Ischaemic Stroke ◽

Radial Nerve ◽

Nerve Palsy ◽

Radial Nerve Palsy ◽

Wrist Extension ◽

Wrist Drop

We describe a patient with pseudoradial nerve palsy caused by acute ischaemic stroke (‘cortical hand’) to emphasise how preserved synkinetic wrist extension following fist closure can distinguish this from peripheral causes of wrist drop.

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