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Radial Nerve Injury at the Wrist
Aka: Radial Nerve Injury at the Wrist, Handcuff Neuropathy
- See Also
- Radial Nerve Injury at the Humerus (Saturday Night Palsy, Crutch Palsy, Wrist Drop)
- Radial Nerve Injury at the Elbow
- Peripheral Nerve Injury
- Pathophysiology
- Radial Nerve superficial branch is susceptible to injury where it crosses the volar wrist
- Nerve crosses over the flexor Retinaculum that encases the Carpal Tunnel
- Compression occurs with any item that tightly binds the wrist in this location
- Superficial Radial Nerve is a Sensory Nerve only (dorsal hand and wrist Sensation)
- Causes
- Any compressive device at the volar wrist (e.g. handcuffs, watches)
- Higher risk if cuffs ride up the Forearm proximally
- Typically affects the dorsal branch of the Radial Nerve with Paresthesias and numbness on the back of the hand
- Symptoms
- Dorsal hand numbness or Paresthesias (especially radial aspect)
- Signs
- Decreased Sensation over dorsal and radial hand, dorsal thumb, dorsal index finger
- Normal hand and wrist motor function
- Management
- Avoid wrist compression
- Consider single Corticosteroid Injection
- Surgery is rarely indicated
- May be considered for refractory course after 3-4 months of conservative therapy
- Course
- Anticipate 3 months to resolution with therapy
- References
- Huisstede (2008) J Hand Surg Am 33(1): 72-8 [PubMed]
- Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]
- Silver (2021) Am Fam Physician 103(5): 275-85 [PubMed]