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14. Radial Nerve Injury.pptx
1.
2. Radial nerve may be injured at the axilla, upper arm, and elbow
3. 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. 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. 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. 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