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The radial nerve is extended from the nerve root in the neck, and supplies sensations and movements to the parts of upper extremities. Radial nerves are a commonly damaged nerves by trauma or external compression.
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- Numbness and a reduction of felt sensations on the back surface of the forearm and hand
- Tingling sensation or pain of the affected upper extremity
- Wirst drop -- the patient cannot extend the wrist and fingers outward when the palm is in a downward position
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- Trauma -- radial nerve injuries often occur with a humerus (upper arm bone) fracture. Because the radial nerve passes through the furrow on the surface of the humerus, it is easily damaged when the humerus is broken. Radial nerve palsy can easily occur with a fracture of the forearm.
- Nerve compression by an anatomical structure surrounding the radial nerve.
- External compression of the radial nerve -- after sleeping with an arm over the back of a chair, the patient experiences a drop in the wrist, tingling, and numbness of the forearm and hand. This form of radial nerve palsy is known as "Saturday night palsy."
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- History and neurologic examination of the upper extremities
- Electromyography and nerve conduction studies
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In many
cases, radial nerve palsy resolves itself. Recovery
may be partial or complete according to the severity of the
nerve damage.
- Conservative treatment -- physical therapy is necessary to minimize the muscle wasting and maximize the muscle function during the recovery period. A wrist splint or brace may be helpful for the functional use of the hand in dealing with a severe wrist drop.
- Surgical decompression is necessary for prolonged radial palsy due to compression by an anatomical structure.
- If the radial nerve function does not return within several months after a humerus fracture, or if radial nerve palsy occurs with an open fracture of the humerus, then surgical exploration is recommended.
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