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Peripheral Nerve Entrapment and Injury in the Upper Extremity.

Sabrina Silver1, Christopher C Ledford1, Kendall J Vogel2

  • 1Eglin Family Medicine Residency Program, Eglin Air Force Base, FL, USA.

American Family Physician
|February 25, 2021
PubMed
Summary
This summary is machine-generated.

Peripheral nerve injuries in the upper extremities, often caused by entrapment, can lead to pain and weakness. Diagnosis relies on history and physical exams, with conservative treatment as the first approach.

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Area of Science:

  • Neurology
  • Orthopedic Surgery

Background:

  • Peripheral nerves in the upper extremities are susceptible to injury and entrapment due to their superficial location and length.
  • Injuries range from mild neurapraxia (ischemia from compression) to severe neurotmesis (full-thickness nerve damage).

Purpose of the Study:

  • To review the common causes, presentation, diagnosis, and management of peripheral nerve injuries and entrapments in the upper extremity.

Main Methods:

  • Literature review focusing on peripheral nerve injuries in the upper extremity.
  • Analysis of injury mechanisms, clinical presentation, diagnostic modalities, and treatment strategies.

Main Results:

  • Common entrapments occur at the shoulder, elbow, and wrist, affecting three main brachial plexus branches.
  • Typical symptoms include pain, weakness, and paresthesia.
  • History and physical examination are key for diagnosis, with advanced imaging (MRI, ultrasonography) and electrodiagnostic studies used to confirm or if conservative treatment fails.

Conclusions:

  • Most nerve injuries managed by family physicians involve neurapraxia due to entrapment.
  • Initial treatment is conservative, with surgery reserved for refractory cases or anatomical abnormalities.