Radial sensory nerve entrapment in the forearm

A group of 51 patients with complaints related to entrapment of the superficial sensory branch of the radial nerve is described. Symptoms included altered sensibility over the dorsoradial aspect of the hand and dorsoradial cutaneous pain with ulnar flexion of the wrist or with gripping and pinching. Pertinent history included compressive or crushing forearm injuries, work activities requiring frequent pronation and wrist hyperextension, and associated illnesses, such as diabetes. Physical examination included abnormal touch perception, abnormal moving two-point discrimination over the dorsoradial area of the hand, a positive Tinel sign in the forearm, and aggravation of the patient's symptoms with forced forearm pronation and wrist ulnar flexion. Seven (37%) of 19 patients treated with nonoperative modalities after a mean of 28 months from the onset of symptoms or their injury were improved. Of the 32 patients treated with surgery with a mean follow-up of 10 months (range of 6 to 29 months), there has been excellent subjective improvement in 37%, good subjective improvement in 49%, and fair subjective improvement in 6%, and 8% were not improved. Of this group of surgically treated patients, 43% have returned to their regular jobs, and 22% are in either vocational rehabilitation or working at a different job.