RADIAL NERVE PALSY

RADIAL NERVE PALSY

RADIAL NERVE PALSY:- Radial nerve is the termination of the posterior cord of the brachial plexus.

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ROOTS

C5-8, T1

CAUSES OF PARALYSIS

1. Hanging down of arm on a chair (Drunkard’s palsy) hanging down of arm from the chair (Saturday night palsy) in a state of intoxication,

2. Fracture of humerus,

3. Use of crutch,

4. Tennis elbow syndrome, etc.

Usual site of compression is in the spiral groove.

CLINICAL FEATURES

1. When the site is in or above the axilla there will be paralysis and atrophy of all muscles it supplies. The important muscles involved are triceps, brachioradialis, supinator and extensors of wrist. Paralysis of triceps leads to difficulty in extending the elbow; during flexion of elbow brachioradialis will not be contracted, hence, supination will be difficult to perform, extension of wrist and fingers is difficult and there may be wrist drop. In an attempt to extend the fingers due to action of interossei and lumbricals there will be flexion of metacarpophalangeal joints and extension of interphalangeal joints. Sensory loss is variable.

2. In injury at the lower third of the arm, triceps, brachioradialis and extensor carpi radialis longus escape paralysis.

PROGNOSIS

Good. Recovery is usual within 1-3 months.

TREATMENT OF RADIAL NERVE PALSY

Splinting is done to maintain extension of the wrist. Elastic extensions are also available. End to end anastomosis of the nerve can be done whenever possible.