Radial neuropathy

Symptoms of radial neuropathy vary depending on the severity of the trauma; however, common symptoms may include wrist drop, numbness on the back of the hand and wrist, and inability to voluntarily straighten the fingers. Loss of wrist extension is due to loss of the ability to move of the posterior compartment of forearm muscles.{{cite journal|last1=Han|first1=Bo Ram|last2=Cho|first2=Yong Jun|last3=Yang|first3=Jin Seo|last4=Kang|first4=Suk Hyung|last5=Choi|first5=Hyuk Jai|title=Clinical Features of Wrist Drop Caused by Compressive Radial Neuropathy and Its Anatomical Considerations|journal=Journal of Korean Neurosurgical Society|date=1 March 2014|volume=55|issue=3|pages=148–151|doi=10.3340/jkns.2014.55.3.148|pmc=4024814|issn=2005-3711|pmid=24851150}} In the event of lacerations to the wrist area the symptom would therefore be sensory. Additionally, depending on the type of trauma, other nerves may be affected such as the median nerve and axillary nerves.{{cite book|last1=Frontera|first1=Walter R.|last2=Silver|first2=Julie K.|author-link2=Julie K. Silver |last3=Rizzo|first3=Thomas D. Jr.|title=Essentials of Physical Medicine and Rehabilitation|publisher=Elsevier Health Sciences|isbn=9780323222723|page=129|url=https://books.google.com/books?id=1sXsAwAAQBAJ&q=radial+neuropathy+symptoms&pg=PA129|access-date=10 September 2016|language=en|date=2014-09-05}}

File:Radial Nerve - Anatomy, Innervation & Distribution - Human Anatomy Kenhub 1.webm

File:Humerus - anterior view.png

There are many ways to acquire radial nerve neuropathy, including:{{cite web|title=Radial Nerve Lesion (C5-C8) Professional Reference {{!}} Patient|url=http://patient.info/doctor/radial-nerve-lesion-c5-c8|website=Patient|access-date=10 September 2016}}

:::::::::::*Upper arm - a fracture of the bone

:::::::::::*Elbow - entrapment of the nerve

:::::::::::*Wrist - elbow deformity and soft-tissue masses

:::::::::::*Axilla - here the most common cause is compression. However, a dislocation of the humerus is a possible factor as well. It could also be due to brachial plexus compression.

The mechanism of radial neuropathy is such that it can cause focal demyelination and axonal degeneration.{{cite journal|last1=Wang|first1=Jack T.|last2=Medress|first2=Zachary A.|last3=Barres|first3=Ben A.|title=Axon degeneration: Molecular mechanisms of a self-destruction pathway|journal=The Journal of Cell Biology|date=9 January 2012|volume=196|issue=1|pages=7–18|doi=10.1083/jcb.201108111|pmid=22232700|url=http://jcb.rupress.org/content/196/1/7.full|access-date=10 September 2016|language=en|issn=0021-9525|pmc=3255986}} These would be caused via laceration or compression of the nerve in question.{{cite book |editor-last=Micheo | editor-first=William |title=Musculoskeletal, Sports and Occupational Medicine|date=2010|publisher=Demos Medical Pub., LLC|location=New York|isbn=9781617050077|page=192|url=https://books.google.com/books?id=uKJY4BDMW24C&q=radial+mononeuropathy+pathogenesis&pg=PA192|access-date=10 September 2016|language=en}}

Radial neuropathy may be diagnosed using MRI, ultrasound, nerve conduction study or electromyography (EMG).

File:Hand anatomy.jpg

The treatment and management of radial neuropathy can be achieved via the following methods:{{Cite web|title=Tendon Transfers: History, Concepts, Timing of Tendon Transfer|url=http://emedicine.medscape.com/article/1245758-overview#a5|date=2017-05-02}}{{cite book|last1=Wolfe|first1=Scott W.|last2=Pederson|first2=William C.|last3=Hotchkiss|first3=Robert N.|last4=Kozin|first4=Scott H.|last5=Cohen|first5=Mark S.|title=Green's Operative Hand Surgery: Expert Consult: Online and Print|publisher=Elsevier Health Sciences|isbn=978-1455737413|page=1078|url=https://books.google.com/books?id=sa-4Qq4LCZYC&q=tendon+transfer+surgery+origin+remains+same+insertion+is+moved&pg=PA1078|access-date=10 September 2016|language=en|date=2010-11-24}}

• Physical therapy or occupational therapy
• Surgery (depending on the specific area and extent of damage)

:*Tendon transfer (the origin remains the same but insertion is moved)

• Splinting

Radial neuropathy is not necessarily permanent, though there could be partial loss of movement or sensation. Complications include deformity of the hand in some individuals.{{cite web|title=Radial nerve dysfunction: MedlinePlus Medical Encyclopedia|url=https://medlineplus.gov/ency/article/000790.htm|website=medlineplus.gov|publisher=NIH|access-date=10 September 2016}} If the injury is axonal (the underlying nerve fiber itself is damaged), recovery may take months or years and full recovery may never occur. EMG and nerve conduction studies are typically performed to diagnose the extent and distribution of the damage, and to help with prognosis for recovery.{{medical citation needed|date=August 2016}}. A compressive neuropraxia of the radial nerve (Saturday night palsy) takes between 2 and 12 weeks to recover. It is a common misunderstanding to attribute severe motor weakness of the hand lasting only minutes to hours to radial nerve neuropraxia

There are a number of terms used to describe radial nerve injuries, which are dependent on the causation factor such as:

• Honeymoon palsy from another individual sleeping on and compressing one's arm overnight.{{cite book|last=Ebnezar|first=John|title=Textbook of Orthopedics|url=https://books.google.com/books?id=7N9JZWber9kC&pg=PA342|year=2010|publisher=JP Medical Ltd|isbn=978-81-8448-744-2|page=342}}
• Saturday night palsy from falling asleep with one's arm hanging over the arm rest of a chair or edge of bed, compressing the radial nerve.{{cite book|last1=Goodman|first1=Catherine C.|last2=Fuller|first2=Kenda S.|title=Pathology for the Physical Therapist Assistant|publisher=Elsevier Health Sciences|isbn=978-1437708936|page=890|url=https://books.google.com/books?id=eJb5RHpCF6oC&q=saturday+night+palsy&pg=PT5203|language=en|date=2011-02-14}}
• Saturnine palsy from lead poisoning{{cite journal |last1=Spinner |first1=Robert J. |last2=Poliakoff |first2=Michael B. |last3=Tiel |first3=Robert L. |date=2002 |title=The Origin of "Saturday Night Palsy"? |url=https://broomedocs.com/wp-content/uploads/2017/07/spinner2002.pdf |journal=Neurosurgery |volume=51 |issue=3 |pages=737-741 |doi=10.1227/01.NEU.0000023989.72999.40 |access-date=October 26, 2023}}
• Squash palsy, from traction forces associated with the sport squash, happens to squash players during periods between matches.{{cite web|title=Medscape /Axillary Nerve Injury Associated With Sports|url=http://www.medscape.com/viewarticle/753230_4|website=www.medscape.com|access-date=10 September 2016}}

• Crutch paralysis
• Peripheral neuropathy

{{Reflist}}

• {{cite journal|last1=Cartwright|first1=Michael S.|last2=Yoon|first2=Joon Shik|last3=Lee|first3=Kyu Ho|last4=Deal|first4=Nicole|last5=Walker|first5=Francis O.|title=Diagnostic Ultrasound for Traumatic Radial Neuropathy|journal=American Journal of Physical Medicine & Rehabilitation|date=1 April 2011|volume=90|issue=4|pages=342–343|doi=10.1097/PHM.0b013e3181e29daa|pmc=2964388|issn=0894-9115|pmid=20531154}}
• {{cite journal|last1=Tuncel|first1=Umut|last2=Turan|first2=Aydin|last3=Kostakoglu|first3=Naci|title=Acute closed radial nerve injury|journal=Asian Journal of Neurosurgery|date=1 January 2011|volume=6|issue=2|pages=106–109|doi=10.4103/1793-5482.92175|pmc=3277063|issn=1793-5482|pmid=22347334 |doi-access=free }}

{{Medical resources

| DiseasesDB =

| ICD10 = {{ICD10|G|56|3|g|50}}

| ICD9 = {{ICD9|354.3}}

| ICDO =

| OMIM =

| MedlinePlus =

| eMedicineSubj = neuro

| eMedicineTopic = 587

| MeshID = D020425

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{{Commons}}

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{{PNS diseases of the nervous system}}

{{Medicine}}

Category:Peripheral nervous system disorders

Category:Symptoms and signs: Nervous system

Category:Mononeuropathies of upper limb