Radial Nerve Injury

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Root Value

C5, C6, C7, C8 AND T1

FROM

Posterior Cord

TO

Posterior Interosseous Nerve

MUSCLE INNERVATION

Posterior Compartment of Arm and Forearm

COMMON SITES AND CAUSES

Injury to Radial Nerve at different levels causes different syndromes with varying motor and sensory deficits.

AXILLA

(1) Saturday night palsy

(2) Crutch Palsy

Motor deficit

Loss of extension of forearm, weakness of supination, and loss of extension of hand and fingers.

Presence of Wrist Drop, inability to extend the hand and fingers.

Sensory deficit

Loss of sensation in lateral arm, posterior forearm, the radial half of hand, and dorsal aspect of radial ​three and a half digits.

ARM

(1) Mid-Shaft Humerus Fracture

(2) Holstein-Lewis Fracture

Motor deficit

Weakness of supination

Loss of extension of hand and fingers

Presence of wrist drop , inability to extend the hand and fingers.

Sensory deficit

Loss of sensation in posterior forearm, the radial half dorsum of hand, and dorsal part of radial ​three and half digits.

Elbow

(1) Neck of radius fracture

(2) Elbow dislocation or fracture

(3) Pressure due to tight cast

(4) Rheumatoid nodules

(5) Injections due to tennis elbow

Deep branch of the radial nerve injury piercing the radial head causing Posterior Interosseous Nerve (PIN) syndrome

Motor deficit

Weakness in extension of hand and loss of extension of fingers

Presence of finger drop, and partial wrist drop

Sensory deficit

None, as sensation is supplied by the superficial radial nerve

Distal forearm:

Wartenberg Syndrome

Motor deficit

None

Sensory deficit

Numbness and tingling in radial half of dorsum of hand, and dorsal aspect of radial ​three and half digits

In Wartenberg’s Syndrome , there is typical radial wrist pain, Finkelstein’s test may be positive

SPECIAL TESTS

RADIAL NERVE TEST

https://youtu.be/kODPvHYNvlU

Upper Limb Neurodynamic Test for Radial Nerve

https://youtu.be/x3ivtuDwCDI

EMG AND NERVE CONDUCTION STUDIES

https://youtu.be/rfbcKF9pENE

Wrist Drop Test

Patient should be seated well during the procedure.

The patient should adopt a praying position with the hands and palms together.

The patient pulls the palm apart.The patient holds hands for about 15 cm apart for a minute.

He should maintain wrist extension till one minute.

The examiner takes note of poor range of motion or the inability to hold wrist in extension.

A positive Wrist Drop Test is the presence of weakness and the inability of a patient to maintain this position of the upper limb

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