RADIAL NERVE PALSY
RADIAL NERVE PALSY
- Radial nerve injury may be high or low.
1) High radial nerve palsy
- Injury is before the spiral groove.
- All muscles supplied by radial nerve are paralysed.
2) Low radial nerve palsy
- Injury is after the spiral groove.
- Low radial nerve palsy may be of two types:-
i) Type I: Injury occurs b/w the spiral groove and elbow joint. Muscles involvement is:
- Elbow extensors (Triceps, anconeus) are spared.
- Wrist, elbow & finger extensors are paralysed
- Sensory loss in first web space (on dorsal side)
ii) Type II: Injury occurs below the elbow joint:
- Elbow extensors (triceps, anconeus), brachioradialis & wrist extensors (ECRL) are spared.
- Finger extensors (extensor digitorum, extensor digiti minimi, extensor indicis), ECRB and thumb extensors (extensor pollicis longus & brevis) are paralysed.
- Sensory loss in first web space (on dorsal side).
CLINICAL FEATURES OF RADIAL NERVE PALSY
- Clinical features depend upon the site of lesion.
1) If lesion is high
- Wrist drop, thumb drop & finger drop.
- Inability to extend elbow, wrist, thumb & fingers (MP joint).
- Patient can extend interphalangeal joints due to action of lumbricals & interossei.
- Sensory loss over posterior surface of arm & forearm and lower lateral half of forearm.
2) If lesion is low
a) Type I
- Wrist drop, thumb drop and finger drop.
- Elbow extension is preserved.
- Sensory loss over the dorsum of first web space.
b) Type II
- Thumb drop & finger drop
- Elbow & wrist extension is preserved
- Sensory loss over the dorsum of first web space
Exam Important
- Lateral & posterior cutaneous nerves of arm and posterior cutaneous nerve of forearm are spared in low radial nerve lesions.
- Most common complication of mid shaft humerus fracture is Radial nerve palsy.
- Wrist drop is seen with Radial nerve palsy.
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