fymili.blogg.se - Radia nerve

Recently, nerve transfer has been reported as a potential alternative to tendon transfer after the complete loss of radial nerve function or a significant delay in treatment.

The surgical options for open radial nerve injuries that result in a loss of nerve continuity include primary repair, nerve grafts, or tendon transfers.

Idiopathic causes of radial nerve paralysis can be treated conservatively after treatable causes such as tumors have been excluded.

A radial nerve paralysis without an associated laceration or penetration is considered“closed.”Fractures of the humerus may result in a closed radial nerve injury that is typically observed for a period of 3 months before surgical exploration.

Treatment options for radial nerve paralysis are dependent upon the primary cause and level of injury.

Rarely, a neuritis or tumor of the radial nerve at levels as high as the brachial plexus will present with radial nerve palsy.

Chronic or acute radial nerve compression can initiate a wide range of clinical symptoms, from weakness in wrist extension to complete radial nerve paralysis.

Acute trauma from lacerations, missiles, injections, or traction can also result in radial nerve paralysis.

Iatrogenic injuries to the radial nerve may occur during complex and routine procedures of the upper extremity. The most common associated cause of radial nerve injury is a fracture to the shaft of the humerus.

All open injuries require exploration, whereas most closed injuries can usually be observed.

The radial nerve is the most frequently injured major nerve in the upper extremity.1 Radial nerve paralysis generally can be divided into either open or closed injuries.

The appropriate management of any radial nerve palsy depends primarily on an accurate determination of it cause,severity,duration,and level of involvement.The radial nerve can be injured as proximally as the brachial plexus or as distally as the posterior interosseous or radial sensory nerve.Radial nerve paralysis,which can result from a complex humerus fracture, direct nerve trauma, compressive neuropathies, neuritis, or (rarely) from malignant tumor formation,has been reported through out the literature,with some controversy regarding its diagnosis and management.Nerve reconstruction posterior interosseous nerve injury radial nerve injury radial nerve palsy tendon transfer.

Cite this article: Bumbasirevic M, Palibrk T, Lesic A, Atkinson HDE. Different techniques are used including direct suture or nerve grafting, vascularised nerve grafts, direct nerve transfer, tendon transfer, functional muscle transfer or the promising, newer treatment of biological therapy. Because radial nerve injuries are the least debilitating of the upper limb nerve injuries, results are usually satisfactory.Conservative treatment certainly has a role, and one of the most important aspects of this treatment is to maintain a full passive range of motion in all the affected joints.Surgical treatment is indicated in cases when nerve transection is obvious, as in open injuries or when there is no clinical improvement after a period of conservative treatment. As a result of its proximity to the humeral shaft, as well as its long and tortuous course, the radial nerve is the most frequently injured major nerve in the upper limb, with its close proximity to the bone making it vulnerable when fractures occur.Injury is most frequently sustained during humeral fracture and gunshot injuries, but iatrogenic injuries are not unusual following surgical treatment of various other pathologies.Treatment is usually non-operative, but surgery is sometimes necessary, using a variety of often imaginative procedures.