Radial nerve palsy caused by spontaneously occurring nerve torsion

✓ An 18-year-old man presented with a spontaneously occurring radial nerve palsy that spared the triceps muscle. At surgery, the portion of the radial nerve located at the midarm level had an hourglass-like appearance. Under magnification, an external—internal neurolysis of the narrowed portion of the hourglass-shaped portion revealed nerve torsion. Straightening of the twisted nerve and fixation accomplished using epiperineurium—fascia stitches to avoid a new torsion resulted in complete functional recovery of the radial nerve.

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Aneurysm-induced third nerve palsy

Journal of Neurosurgery ◽

10.3171/jns.1972.36.5.0548 ◽

1972 ◽

Vol 36 (5) ◽

pp. 548-551 ◽

Cited By ~ 25

Author(s):

Iftikhar A. Raja

Keyword(s):

Subarachnoid Hemorrhage ◽

Functional Recovery ◽

Poor Prognosis ◽

Nerve Palsy ◽

Nerve Function ◽

Content Type ◽

Third Nerve Palsy ◽

Carotid Ligation ◽

Third Nerve ◽

Fine Print

✓ Forty-two patients with aneurysm-induced third nerve palsy are described. After carotid ligation, 58% showed satisfactory and 42% unsatisfactory functional recovery. In some patients the deficit continued to increase even after carotid ligation. Early ligation provided a better chance of recovery of third nerve function. Patients in whom third nerve palsy began after subarachnoid hemorrhage had a poor prognosis. No relationship was noted between the size of the aneurysm and the recovery of third nerve function.

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Surgical management and outcome in patients with radial nerve lesions

Journal of Neurosurgery ◽

10.3171/jns.2001.95.4.0573 ◽

2001 ◽

Vol 95 (4) ◽

pp. 573-583 ◽

Cited By ~ 60

Author(s):

Daniel H. Kim ◽

Andrew C. Kam ◽

Padmavathi Chandika ◽

Robert L. Tiel ◽

David G. Kline

Keyword(s):

Surgical Management ◽

Radial Nerve ◽

Gunshot Wounds ◽

Suture Repair ◽

Content Type ◽

Louisiana State University ◽

Internal Neurolysis ◽

End To End ◽

Grade 3 ◽

Fine Print

Object. The goal of this paper was to review surgical management and outcomes in patients treated for radial nerve (RN) lesions at Louisiana State University Health Sciences over a period of 30 years. Methods. Two hundred sixty patients with RN injuries were evaluated. The most common mechanisms of injuries involving the RN included fracture of the humerus, laceration, blunt contusions, and gunshot wounds. One hundred and eighty patients (69%) underwent surgery. Lesions not in continuity required primary or secondary end-to-end suture repairs or graft repairs. With the use of direct intraoperative nerve action potential recording, RN injuries in which the lesion was in continuity required external or internal neurolysis or resection of the lesion followed by end-to-end suture or graft repair. A minimum of 1.5 years follow-up review was available in 90% of the patients who underwent surgery. Motor function recovery to Grade 3 or better was observed in 10 (91%) of 11 patients who underwent primary suture repair, 25 (83%) of 30 who underwent secondary suture repair, 43 (80%) of 54 who received graft repair, and 63 (98%) of 64 in whom neurolysis was performed. Sixteen (71%) of 21 patients with superficial sensory RN injury achieved satisfactory pain relief after complete resection of a neuroma or neurolysis. Conclusions. This study clearly demonstrates that excellent functional recovery can be achieved with proper surgical management of RN injuries.

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Alternative to tarsorrhaphy in peripheral facial nerve palsy with expectation of functional recovery

Journal of Neurosurgery ◽

10.3171/jns.1984.61.2.0405 ◽

1984 ◽

Vol 61 (2) ◽

pp. 405-406 ◽

Cited By ~ 1

Author(s):

Eduardo Fernandez ◽

Roberto Pallini ◽

Giulio Maira

Keyword(s):

Facial Nerve ◽

Functional Recovery ◽

Nerve Palsy ◽

Simple Technique ◽

Facial Nerve Palsy ◽

Nerve Function ◽

Content Type ◽

Peripheral Facial Nerve Palsy ◽

Opening And Closing ◽

Fine Print

✓ A simple technique is described for protecting the cornea in patients with peripheral facial nerve palsy while waiting for recovery of nerve function. The application of an adhesive strip to the superior eyelid permits opening and closing of the eye, and provides good protection of the cornea.

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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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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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