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Nontraumatic paralysis of the radial nerve with multiple constrictions
Pan Yongwei1, Tian Guanglei, Wei Jianing
1Department of Hand Surgery, Jishuitan Hospital, Beijing, People's Republic of China.
Purpose:
To present an uncommon lesion of radial nerve paralysis with multiple constrictions.
Method:
Eight patients were treated in our department between January 1994 and August 2000. There were 4 men and 4 women with a mean age of 26 years (10-43 y). The radial nerves of all patients were explored. There were 1 to 5 segmental constrictive lesions at the main trunks of the radial nerves or the posterior interosseous nerves; no obvious extrinsic compression was noted. Epineurolysis was performed in 3 patients, in the other 5 patients the constricted portions of the nerves were resected, and neurorrhaphy was performed in 2 patients, nerve-grafting in 3. Histologic examination of the resected portions showed concentration of inflammatory cells around the vessels in the perineurium.
Results:
The patients were followed-up for 6 months to 4 years after surgery. Seven patients had at least grade 4 muscle strength in the involved muscles. One patient who was treated by external neurolysis 15 months after onset had no signs of recovery 10 months after surgery.
Conclusions:
Nontraumatic paralysis of the radial nerve with multiple constrictions is very uncommon. The etiology may be a focal inflammatory response around the feeding arteries in the perineurium.