Robert Wartenberg Syndrome and Sign: A Review Article

Background: Robert Wartenberg, a European-American neurologist, was born in 1887 and died in 1956. His description of radial sensory nerve compression at the forearm is memorialized as Wartenberg’s syndrome. He recognized that involuntary abduction of the little finger could be caused by ulnar nerve palsy - a finding often called Wartenberg’s sign Syndrome and signs are reviewed, and a brief biography is presented. Objective: To review Wartenberg’s sign and Wartenberg’s syndrome. Discussion: Compression of the superficial branch of the radial nerve, often called Wartenberg’s syndrome, is characterized by pain, paresthesia, and dysesthesia along the dorsoradial distal forearm. Non-operative treatment can include activity restriction and anti-inflammatory medication. If symptoms persist, surgical decompression of the radial nerve is an option. The abducted posture of the little finger - Wartenberg’s sign - can result from a low ulnar nerve palsy. Tendon transfer can be performed to correct this deformity. Conclusion: Compression of the superficial branch of the radial nerve and abducted posture of the little finger were described by Robert Wartenberg and carry his name as eponymous syndrome and sign, respectively.

Wartenberg’s Syndrome: Diagnosis and Treatment

Wartenberg’s syndrome is a peripheral neuropathy caused by entrapment of the superficial radial nerve (SRN), presenting with paresthesia in the nerve distribution [1]. Currently, there are no established guidelines or recommendations for the proper treatment of this condition. As such, the objective of this paper is to complete a literature review outlining the diagnosis and treatment of Wartenberg’s syndrome.

SUPERFICIAL BRANCH OF THE RADIAL NERVE PIERCING THE BRACHIORADIALIS TENDON TO BECOME SUBCUTANEOUS: AN ANATOMICAL VARIATION WITH CLINICAL RELEVANCE

We dissected 20 preserved Caucasian cadaveric upper limbs looking at the relation of the superficial branch of the radial nerve (SBRN) to the brachioradialis tendon. SBRN emerged from deep to superficial position by piercing the brachioradialis tendon near its dorsal border in four limbs. The resulting dorsal tendinous band compressed the nerve and prevented longitudinal gliding movement during ulnar flexion. This is likely to increase the risk of chronic compression neuropathy (Wartenberg's syndrome). In two of these four limbs, there was a communication between the SBRN and lateral cutaneous nerve of the forearm. No such communication was found in the remaining 16 forearms. This communication could contribute to the minimal area of sensory loss observed in Wartenberg's syndrome. We recommend that this anatomical anomaly is looked for and if present dealt with during surgical treatment of Wartenberg's syndrome, as it is likely to predispose to chronic compression neuropathy.