Ultrasonographic and Surgical Findings of Acute Radial Neuropathy Following Blunt Trauma

A Case Report

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2 Citations (Scopus)

Abstract

ABSTRACT: Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action. The left superficial radial sensory territory was intact. Electrodiagnostic findings suggested severe left radial neuropathy around the distal arm with sensory sparing. Ultrasonographic study demonstrated 2 stenotic lesions around the distal arm and absence of the left superficial radial sensory nerve. Surgical exploration revealed 2 stenotic lesions with twisting of the nerve, concordant with ultrasonographic study. End-to-end anastomosis was performed in the proximal lesion. Sixteen months later, wrist and finger extension was grade 3, and reinnervation signs in the radial-innervated muscles except extensor indicis muscle were observed. The complementary relationship between electrophysiologic and ultrasonographic examinations is very important for precise lesion location and decision making for treatment of peripheral nerve injury.

Original languageEnglish
JournalAmerican Journal of Physical Medicine and Rehabilitation
DOIs
Publication statusAccepted/In press - 2016 Apr 15

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Radial Neuropathy
Arm
Wrist
Radial Nerve
Wounds and Injuries
Elbow
Fingers
Decision Making
Pain
Peripheral Nerve Injuries
Muscles
Therapeutics

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

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title = "Ultrasonographic and Surgical Findings of Acute Radial Neuropathy Following Blunt Trauma: A Case Report",
abstract = "ABSTRACT: Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action. The left superficial radial sensory territory was intact. Electrodiagnostic findings suggested severe left radial neuropathy around the distal arm with sensory sparing. Ultrasonographic study demonstrated 2 stenotic lesions around the distal arm and absence of the left superficial radial sensory nerve. Surgical exploration revealed 2 stenotic lesions with twisting of the nerve, concordant with ultrasonographic study. End-to-end anastomosis was performed in the proximal lesion. Sixteen months later, wrist and finger extension was grade 3, and reinnervation signs in the radial-innervated muscles except extensor indicis muscle were observed. The complementary relationship between electrophysiologic and ultrasonographic examinations is very important for precise lesion location and decision making for treatment of peripheral nerve injury.",
author = "Choi, {Seok Youl} and Park, {Jong Woong} and Kim, {Dong Hwee}",
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N2 - ABSTRACT: Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action. The left superficial radial sensory territory was intact. Electrodiagnostic findings suggested severe left radial neuropathy around the distal arm with sensory sparing. Ultrasonographic study demonstrated 2 stenotic lesions around the distal arm and absence of the left superficial radial sensory nerve. Surgical exploration revealed 2 stenotic lesions with twisting of the nerve, concordant with ultrasonographic study. End-to-end anastomosis was performed in the proximal lesion. Sixteen months later, wrist and finger extension was grade 3, and reinnervation signs in the radial-innervated muscles except extensor indicis muscle were observed. The complementary relationship between electrophysiologic and ultrasonographic examinations is very important for precise lesion location and decision making for treatment of peripheral nerve injury.

AB - ABSTRACT: Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action. The left superficial radial sensory territory was intact. Electrodiagnostic findings suggested severe left radial neuropathy around the distal arm with sensory sparing. Ultrasonographic study demonstrated 2 stenotic lesions around the distal arm and absence of the left superficial radial sensory nerve. Surgical exploration revealed 2 stenotic lesions with twisting of the nerve, concordant with ultrasonographic study. End-to-end anastomosis was performed in the proximal lesion. Sixteen months later, wrist and finger extension was grade 3, and reinnervation signs in the radial-innervated muscles except extensor indicis muscle were observed. The complementary relationship between electrophysiologic and ultrasonographic examinations is very important for precise lesion location and decision making for treatment of peripheral nerve injury.

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