J Korean Med Assoc.  2017 Dec;60(12):958-962. 10.5124/jkma.2017.60.12.958.

Radial nerve neuropathy

• Jang HS
• Lee YH

• KMID: 2397864
• DOI: http://doi.org/10.5124/jkma.2017.60.12.958

Abstract

Radial nerve entrapment or compression in the upper extremity is relatively rare compared to medial nerve or ulnar nerve entrapment and compression. Various syndrome types are defined according to the location of radial nerve entrapment and the pattern of symptom expression. In the upper arm, Saturday night palsy or honeymoon palsy occurs. Around the elbow, posterior interosseous nerve entrapment syndrome, which involves pure motor symptoms, and radial tunnel syndrome, which mainly involves pain symptoms, can develop. Finally, superficial radial nerve entrapment occurs in the distal forearm and has the symptom of painful or abnormal sensory disturbances of the hand. Conservative treatment is usually the first choice for radial nerve neuropathy, unless there is motor paralysis. Surgical treatment can be considered if there is no improvement after adequate conservative treatment.

Keyword

Radial nerve; Entrapment neuropathy; Paralysis

MeSH Terms

Arm
Elbow
Forearm
Hand
Nerve Compression Syndromes
Paralysis
Radial Nerve*
Radial Neuropathy
Ulnar Nerve Compression Syndromes
Upper Extremity

Figure

• 

  Figure 1 Radial nerve palsy with transverse humeral shaft fracture showing distracted fracture gap. (A) Preoperative radiograph. (B) Long distracted radial nerve injury. (C) After nerve repair and bone fixation. (D) Postoperative radiograph.

• 

  Figure 2 Intraoperative photos of patient with giant cell tumor of proximal radius. These show anatomic course of posterior interosseous nerve around the elbow. (A) Resected posterior interosseous nerve just lateral to the radial head. It runs dorsally along radius neck and through supinator muscle. (B) Proximal radial nerve identified anterior to the distal humerus. (C) Clinical photo after neurorrhaphy.

Reference

1. Latinovic R, Gulliford MC, Hughes RA. Incidence of common compressive neuropathies in primary care. J Neurol Neurosurg Psychiatry. 2006; 77:263–265.

2. Stanley J. Radial tunnel syndrome: a surgeon's perspective. J Hand Ther. 2006; 19:180–184.

3. Moradi A, Ebrahimzadeh MH, Jupiter JB. Radial tunnel syndrome, diagnostic and treatment dilemma. Arch Bone Jt Surg. 2015; 3:156–162.

4. Dang AC, Rodner CM. Unusual compression neuropathies of the forearm. Part I: radial nerve. J Hand Surg Am. 2009; 34:1906–1914.

5. Eaton CJ, Lister GD. Radial nerve compression. Hand Clin. 1992; 8:345–357.

6. Hashizume H, Nishida K, Nanba Y, Shigeyama Y, Inoue H, Morito Y. Non-traumatic paralysis of the posterior interosseous nerve. J Bone Joint Surg Br. 1996; 78:771–776.

7. Michele AA, Krueger FJ. Lateral epicondylitis of the elbow treated by fasciotomy. Surgery. 1956; 39:277–284.

8. Roles NC, Maudsley RH. Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment. J Bone Joint Surg Br. 1972; 54:499–508.

9. Lister GD, Belsole RB, Kleinert HE. The radial tunnel syndrome. J Hand Surg Am. 1979; 4:52–59.

10. Loh YC, Lam WL, Stanley JK, Soames RW. A new clinical test for radial tunnel syndrome: the Rule-of-Nine test: a cadaveric study. J Orthop Surg (Hong Kong). 2004; 12:83–86.

11. Kupfer DM, Bronson J, Lee GW, Beck J, Gillet J. Differential latency testing: a more sensitive test for radial tunnel syndrome. J Hand Surg Am. 1998; 23:859–864.

12. Ferdinand BD, Rosenberg ZS, Schweitzer ME, Stuchin SA, Jazrawi LM, Lenzo SR, Meislin RJ, Kiprovski K. MR imaging features of radial tunnel syndrome: initial experience. Radiology. 2006; 240:161–168.

13. Sotereanos DG, Varitimidis SE, Giannakopoulos PN, Westkaemper JG. Results of surgical treatment for radial tunnel syndrome. J Hand Surg Am. 1999; 24:566–570.

14. Huisstede B, Miedema HS, van Opstal T, de Ronde MT, Verhaar JA, Koes BW. Interventions for treating the radial tunnel syndrome: a systematic review of observational studies. J Hand Surg Am. 2008; 33:72–78.