Cryosurgery for chronic injuries of the cutaneous nerve in the upper limb. Analysis of a new open technique.
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We have treated six patients with chronic pain following nerve injury using a cryosurgical probe. All had a significant return of hand function and improvement of pain during a mean follow-up of 13.5 months. Open visualisation of the injured nervous tissue is essential for patients undergoing this technique. Four patients regained normal sensation in the dermatome of the previously injured nerve. (+info)
Ultrasonographic appearance of supinator syndrome.
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OBJECTIVE: To describe ultrasonographic findings in 4 patients with supinator syndrome (i.e., deep branch of the radial nerve). METHODS: Four patients with weakness and pain in their forearm underwent ultrasonographic examination with subsequent electroneurographic testing and surgical nerve inspection. Normal measurements of the deep branch of the radial nerve in 10 healthy volunteers served as comparison for measurements in the patients. RESULTS: An enlarged deep branch of the radial nerve was found in all 4 patients at the affected side. Electroneurographic testing and surgical inspection confirmed the ultrasonographic findings. The mean transverse diameter was 4.2 mm (range, 3.8-4.5 mm), and the anteroposterior diameter was 3.3 mm (range, 2.5-3.8 mm). In volunteers, the mean transverse diameter was 2.13 mm (range, 1.7-2.6 mm), and the mean anteroposterior diameter was 1.3 mm (range, 1.0-1.5 mm). CONCLUSIONS: The deep branch of the radial nerve appears enlarged in patients with supinator syndrome. (+info)
Radial nerve palsy in an elite bodybuilder.
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A case is reported of high radial nerve palsy in an elite bodybuilder caused by an extrinsic mass effect of muscular hypertrophy. Surgical decompression resulted in complete clinical resolution. (+info)
Radial nerve compression by a large cephalic vein aneurysm: case report.
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A 43-year-old man had weakness of the extensor muscles in the right forearm and could not extend the right wrist. The apparent disorder was caused by radial nerve compression by a large aneurysm in the cephalic vein in the antecubital fossa. Surgical resection of the aneurysm resolved the symptoms. This exceedingly rare complication of venous aneurysm is discussed. Venous aneurysm should be included in the differential diagnosis of a subcutaneous mass, and diagnosis is best made with Duplex ultrasound scanning. Surgical excision is the appropriate treatment. (+info)
Radial nerve paralysis due to Kent retractor during upper abdominal operation.
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After general anesthesia, peripheral nerve paralysis is a rare complication. The frequently damaged nerves including: branches of the brachial plexus, the ulnar, radial and common peroneal nerves, and sometimes the facial nerve. The radial nerve is the most infrequently damaged one, accounting for only 3% of nerve damage. We report a case of radial nerve paralysis due to self retractor during abdominal operation, its clinical findings, and review of the literature on peripheral nerve paralysis. (+info)
Investigation of two possible compression sites of the deep branch of the radial nerve and nerve supply of the extensor carpi radialis brevis muscle.
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The posterior interosseous nerve arises from the deep branch of the radial nerve, and compression by adjacent structures results in posterior interosseous nerve syndrome. Sixty upper limbs from 30 Turkish subjects (18 males and 12 females) were dissected to reveal the course of the posterior interosseous nerve and to examine possible compression sites at the proximal and distal edges of the supinator muscle, and the exit of the nerve from the extensor carpi radialis brevis muscle. Posterior interosseous nerve syndrome is most probably caused by the tendinous part of the supinator muscle at the proximal edge. (+info)
Complications of treating distal radius fractures with external fixation: a community experience.
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OBJECTIVE: To analyze the immediate postoperative complications associated with treating distal radius fractures with external fixation. DESIGN: A retrospective chart review of data obtained from 24 consecutive patients who were treated with small AO external fixators in 1997. SETTING: Two community medical centers. INTERVENTION: Preoperative and postoperative radiograph measurements were taken of radial inclination, radial tilt, and radial length, and fractures were classified according to the AO system. Patient charts were reviewed to document demographics, type of fixator used, open or percutaneous technique for pin placement, use of augmentation, additional operations, and complications. MAIN OUTCOME MEASUREMENTS: Complications associated with treating distal radius fractures with one type of external fixator. RESULTS: Sixteen of the 24 patients had complications: 5 with neuropathies of the median or superficial radial nerve, 9 with pin track infections, 2 with pin loosening, one with a nonunion, 2 with malunion, and 4 patients each with radial shortening, loss of radial tilt, collapse of ulnar border or volar intercalated segment instability (VISI) of the lunate and rotatory subluxation of the scaphoid. CONCLUSIONS: Postoperative complications following distal radius fractures treated with external fixation are common. Their effect, however, on long term functional results and patient satisfaction is negligible, with the exception of those patients with complications intrinsic to the fracture itself, i.e., nonunion, malunion or carpal malalignment. (+info)
Thrower's fracture of the humerus with radial nerve palsy: an unfamiliar softball injury.
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A fracture of the normal humerus in a healthy young adult most commonly results from significant direct trauma. Throwing sports have become increasingly popular outside of North America and bring with them a novel injury mechanism for clinicians. A 21 year old woman sustained a "thrower's fracture" of the distal humerus and radial nerve palsy while throwing a softball. She was treated by internal fixation. Her fracture united, and radial nerve neurapraxia resolved after 8 weeks. Clinicians should be aware of this entity so that prodromal symptoms can be recognised early and thrower's fractures are not investigated unnecessarily. (+info)