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Muscle & Nerve Aug 2022
Topics: Humans; Nerve Compression Syndromes; Radial Nerve; Radial Neuropathy
PubMed: 35621077
DOI: 10.1002/mus.27646 -
Harefuah Mar 2023The radial tunnel syndrome (RTS) is an entrapment of the radial nerve in the forearm. It is characterized by pain focused on the trapping area in the proximal forearm as...
The radial tunnel syndrome (RTS) is an entrapment of the radial nerve in the forearm. It is characterized by pain focused on the trapping area in the proximal forearm as well as pain radiated down the forearm. The syndrome is more common in men and in our estimation, there is a circumstantial connection to the continuous use of the computer keyboard. Radial tunnel syndrome is a consequence of nerve entrapment in the tunnel, which is formed from a covering consisting of the supinator muscle and the distal margins of this muscle. There is a clear association between radial tunnel syndrome and the occurrence of tennis elbow. The sensitivity in nearby locations along with the lack of familiarity of some of the clinicians with RTS lead to misdiagnosis and therefore, even to mistreatment in some cases. The physical examination is the most important means of making the correct diagnosis. The treatment of radial tunnel syndrome is divided into the conservative one in which emphasis is placed on physiotherapy and mobilizations of the nerve and the surgical one during which decompression of the radial canal is performed and in fact release of pressure at the exact anatomical location.
Topics: Male; Humans; Radial Neuropathy; Radial Nerve; Elbow; Tennis Elbow; Nerve Compression Syndromes; Pain
PubMed: 36966371
DOI: No ID Found -
The Journal of Hand Surgery May 2023Peripheral neuropathy can affect sensory, motor, or autonomic nerves and manifest with a variety of symptoms. Tuberculosis as a major infectious disease that often...
Peripheral neuropathy can affect sensory, motor, or autonomic nerves and manifest with a variety of symptoms. Tuberculosis as a major infectious disease that often affects many organs of the body. However, primary involvement of peripheral nerves is unusual. Peripheral neuropathy in patients with tuberculosis often is associated with other comorbidities, such as immunocompromised states, diabetes mellitus, malnutrition, and some antitubercular medications. This report describes the rare finding of peripheral tubercular neuritis with caseating abscesses of right median and radial nerve in a healthy 24-year man.
Topics: Male; Humans; Peripheral Nervous System Diseases; Neuritis; Peripheral Nerves; Radial Nerve; Tuberculosis
PubMed: 36922292
DOI: 10.1016/j.jhsa.2023.02.002 -
Operative Orthopadie Und Traumatologie Feb 2020Peripheral nerve blocks in hand surgery. (Review)
Review
OBJECTIVE
Peripheral nerve blocks in hand surgery.
INDICATIONS
Short operations on the hand.
CONTRAINDICATIONS
Long operations, polyneuropathy, local anesthesia allergy.
TECHNIQUE
Identification of landmarks, skin disinfection, local anesthesia injection, surgery.
POSTOPERATIVE MANAGEMENT
Postoperative monitoring.
RESULTS
We performed 75 hand surgeries using distal nerve blocks over 3 years (between 2015 and 2018) in our department. In all, 60% (n = 45) of cases belong to the innervation region of the median nerve, 28% of cases (n = 21) belong to the innervation area of the radial nerve and about 5% (n = 4) to the innervation area of the ulnar nerve. In 7% (n = 5) of cases, anesthesia of two neighboring innervation areas was necessary. The distal nerve block provides a reliable form of anesthesia in hand surgery with low complication rates.
Topics: Hand; Humans; Nerve Block; Radial Nerve; Treatment Outcome; Ulnar Nerve
PubMed: 31897502
DOI: 10.1007/s00064-019-00639-6 -
Journal of Clinical Orthopaedics and... Aug 2023Humeral shaft fracture is a common injury which can be treated either conservatively with functional bracing or with surgical fixation. Current evidence shows an... (Review)
Review
Humeral shaft fracture is a common injury which can be treated either conservatively with functional bracing or with surgical fixation. Current evidence shows an increase in the rate of nonunion after conservative treatment, suggesting that indications for conservative treatment may need to be re-examined. This article updates trends in treatment for humeral shaft fracture. Indications for surgery, both for plate osteosynthesis with open reduction and internal fixation (ORIF) as well as for minimally invasive plate osteosynthesis (MIPO) and intramedullary nailing (IMN) are described. Recognition of the advantages and disadvantages of each technique can better define the role of the plate or nail and can aid in the selection of an appropriate surgical approach. ORIF with compression plate continues to have a role in the treatment of simple or AO/OTA type A fractures. The primary goal of minimal invasive osteosynthesis, a surgical technique involving small incisions, closed reduction or mini-open reduction that minimizes soft tissue dissection and helps preserve the periosteal blood supply, is to achieve bone union and the best possible functional outcomes. MIPO of the humerus is now well accepted as being less invasive and providing relative stability to allow indirect (secondary) bone healing with callus formation. MIPO approaches can be performed circumferentially to the humerus, including the proximal, middle and distal shaft. The classic MIPO approach is anterior MIPO, followed by posterior, anterolateral and anteromedial MIPO. IMN is also an option for treating humerus fractures. In the past, IMN was not widely used due to the potential for complications such as shoulder impingement and elbow problems as well as the limited availability of implants and the steep learning curve of this surgical technique. Over the past decade, the launch of a new design of straight antegrade and retrograde IMN with established techniques has encouraged more surgeons to use IMN as an alternative option. Methods of dealing with concomitant and post-treatment radial nerve palsy have also been evolving, including the use of ultrasound for diagnosis of radial nerve conditions. Radial nerves with contusion, entrapment or laceration can be detected using ultrasound with reliability comparable to intraoperative findings. Trends in treatment of radial nerve palsy are described below. Future larger randomized controlled trials comparing conservative and operative management are necessary to further develop appropriate guidelines.
PubMed: 37588079
DOI: 10.1016/j.jcot.2023.102230 -
Seminars in Neurology Oct 2019Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a... (Review)
Review
Entrapment neuropathies are defined as compression of peripheral nerves due to known or unknown causes. The high incidence and variety of presentations require a comprehensive knowledge of these conditions, especially in neurology and orthopedic surgery clinical practices. Detailed knowledge of topographic anatomy, clinical manifestations, and appropriate use of electrophysiological studies with selective addition of neuromuscular ultrasonography are needed to establish an early and accurate diagnosis to advice patients and provide them with a comprehensive treatment plan. In this article, we discuss the most common forms of entrapment neuropathies in the upper and lower extremities.
Topics: Humans; Nerve Compression Syndromes; Peroneal Nerve; Radial Nerve; Tibial Nerve; Ultrasonography
PubMed: 31639838
DOI: 10.1055/s-0039-1693004 -
Anesthesiology and Pain Medicine Feb 2021The anatomy of the radial nerve is prone to entrapment, each with different symptomology. Compression of entrapment of the radial nerve can occur near the... (Review)
Review
CONTEXT
The anatomy of the radial nerve is prone to entrapment, each with different symptomology. Compression of entrapment of the radial nerve can occur near the radiocapitellar joint, the spiral groove, the arcade of Frohse, the tendon of the extensor carpi radialis brevis (ECRB), and at the radial tunnel. Those who require repetitive motions are at increased risk of peripheral neuropathy syndromes, including repetitive pronation and supination, trauma, or systemic disease; however, t the influence of all risk factors is not well understood. Depending on the location of entrapment, radial nerve entrapment syndrome presents different symptoms. It may include both a motor component and a sensory component. The motor component includes a dropped arm, and the sensory component can include pain and paresthesia in the distribution of the radial nerve that resolves with rest and exacerbates by repetitive pronation and supination.
EVIDENCE ACQUISITION
Diagnostic evaluation for radial nerve entrapment, apart from clinical symptoms and physical exam, includes electromyography, nerve conduction studies, ultrasonography, and magnetic resonance imaging. Conservative management for radial nerve entrapment includes oral anti-inflammatory medications, activity modification, and splinting. Some recently performed studies mentioned promising minimally invasive techniques, including corticosteroid injections, peripheral nerve stimulation, and pulsed radiofrequency.
RESULTS
When minimally invasive techniques fail, open or endoscopic surgery can be performed to release the nerve.
CONCLUSIONS
Endoscopic surgery has the benefit of decreasing incision size and reducing time to functional recovery.
PubMed: 34221946
DOI: 10.5812/aapm.112823