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Proximal radial compression neuropathy.

Brian Rinker1, Charles R Effron, Robert W Beasley

  • 1Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY. brink2@uky.edu

Annals of Plastic Surgery
|January 28, 2004
PubMed
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Proximal radial nerve compression, though uncommon, presents with distinct forearm pain and tenderness. Surgical decompression offers excellent symptom relief and return to work for most patients.

Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Nerve Compression Syndromes

Background:

  • Proximal radial nerve compression is a rare condition.
  • Diagnosis is often challenging due to infrequent occurrence and subtle presentation.
  • Understanding common symptoms and diagnostic predictors is crucial for effective management.

Purpose of the Study:

  • To review a large clinical series of proximal radial nerve compression neuropathies.
  • To identify common symptoms, physical examination findings, and electrodiagnostic results.
  • To determine predictors of surgical decompression outcomes.

Main Methods:

  • Retrospective review of 79 proximal radial compression neuropathies in 71 patients treated between 1991 and 2000.
  • Analysis of presenting symptoms, physical findings, electrodiagnostic results, operative findings, and patient outcomes.

Related Experiment Videos

  • Surgical decompression was performed by a single surgeon.

    • Main Results:

    • Consistent symptoms included deep forearm aching, radiating pain to the neck/shoulder, and arm heaviness.
    • Common physical findings were tenderness over the radial nerve at the supinator muscle, pain on resisted supination, and a positive Tinel sign.
    • Electrophysiologic studies were largely unhelpful, with 90% of patients showing normal findings.
    • Posterior interosseous nerve pathology was noted in 46% of cases during surgery.
    • Excellent or good recovery was achieved in 97% of surgical decompressions.
    • 60 of 69 employed patients returned to work, with 53 resuming their regular jobs.

    Conclusions:

    • Proximal radial compression neuropathies present with a characteristic set of symptoms and physical findings.
    • Surgical decompression is an effective treatment, leading to excellent symptom relief and functional recovery.
    • Early diagnosis and surgical intervention can significantly improve patient outcomes and return to employment.