Peripheral Nerve Entrapment and Injury in the Upper Extremity

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.