14. Radial Nerve Injury.pptx

injury radial nerve

1. Radial nerve palsy

2. Radial nerve may be injured at the axilla , upper arm , and elbow

3. Clinical feature : low lesion Due to fracture or dislocation at the elbow , or to a local wound Iatrogenic lesions of the PIN (posterior interosseus nerve ) where it winds through the supinator muscle are sometimes seen after operations on the proximal end of the radius. Patients complains of clumsiness and on testing cannot extend the metacarpophalangeal joints of the hand . In the thus there is also weakness of thumb extension and retroposition . The wrist is seen to extend into radial deviation Wrist extension is preserved

4. Clinical feature : high lesions Due to fracture of the humerus or after prolonged tourniquet pressure . There is obvious wrist drop , due to weakness of the radial extensor of the wrist Inability to extend the metacarpophalangeal joint or elevate the thumb Sensory loss is limited to a small patch on the dorsum around the anatomical snuffbox

5. Clinical feature : very high lesions May be caused by trauma or operation of the shoulder Chronic compression in the axilla , this is seen in drink and drug addict who fall into a stupor with the arm dangling over the back of a chair ( Saturday night palsy ), thin elderly patient using “ cruth palsy ” Weakness of the wrist and the hand The triceps is paralyzed and the triceps reflex is absent

6. treatment Open injuries should be explored and the nerve repaired or grafted as soon as possible Closed injuries are usually neuropraxia or conduction block lesions , and function eventually returns Extension splint and passive movement small joint of the hand for while recovery is awaited to prevent fixed contracture Tendon transfer for the fixed dissability