Orthopedics Book


Radial Nerve Injury at the Wrist

Aka: Radial Nerve Injury at the Wrist, Handcuff Neuropathy
  1. See Also
    1. Peripheral Nerve Injury
  2. Pathophysiology
    1. Radial Nerve superficial branch is susceptible to injury where it crosses the volar wrist
      1. Nerve crosses over the flexor Retinaculum that encases the Carpal Tunnel
      2. Compression occurs with any item that tightly binds the wrist in this location
  3. Causes
    1. Any compressive device at the volar wrist (e.g. handcuffs, watches)
  4. Symptoms
    1. Dorsal hand numbness (especially radial aspect)
  5. Signs
    1. Decreased sensation over dorsal and radial hand, dorsal thumb, dorsal index finger
    2. Normal hand and wrist motor function
  6. Management
    1. Avoid wrist compression
    2. Consider single Corticosteroid Injection
    3. Surgery for this is rare
  7. Course
    1. Anticipate 3 months to resolution with therapy
  8. References
    1. Huisstede (2008) J Hand Surg Am 33(1): 72-8 [PubMed]
    2. Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]

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