Advertisement

Radial Nerve Entrapment at the Elbow

  • Esther VögelinEmail author
  • Dietmar Bignion
  • Franck Leclère
  • Celli Andrea
  • Bonucci PierLuigi
  • de Luise Guglielmo
Chapter

Abstract

Radial nerve injuries, at different levels, have been reported in swimming, tennis, golf, weight lifting, and several kinds of throwing sports. The mechanisms of injury include direct trauma and compression injuries. Radial tunnel syndrome is an uncommon pathology. However 5–8% of patients with chronic lateral epicondylitis have involvement of the posterior interosseous nerve (Celli et al. Treatment of elbow lesions. Spinger 281–297, 2008).

It is important to differentiate the two clinical syndromes related to the radial nerve.

The radial tunnel syndrome (RTS) is a compression of the radial nerve in a potential space four fingerbreadths long, located along the anterior aspect of the proximal radius, whereas the posterior interosseous nerve (PIN) syndrome relates to a compression of the PIN, with weakness of its muscles. There is weakness of extension of all of the digits, with sparing of the extensor carpi radialis brevis (ECRB).

The proximal radial nerve compression sites include fibrous bands between brachial and brachioradialis muscle anterior to the radiocapitellar joint, recurrent radial vessels (leash of Henry) at the radial neck, bands at the medial proximal edge of ECRB muscle or at the Frohse arcade (proximal edge of the superficial portion of the supinator muscle), as well as at the distal edge of the supinator muscle. The most common site includes membranous or tendinous fibers of the proximal edge of the supinator muscle. Surgery indicated if clinical symptoms of radial nerve entrapment despite conservative treatment persist.

Keywords

Radial nerve Anatomy Indication for release 

Notes

Acknowledgments

Declaration of Conflict of Interest: The authors declare that they have no conflicts of interest concerning this article.

References

  1. 1.
    Celli A, Rovesta C, Marongiu MC. Elbow nerve tunnel syndromes I. In: Celli A, Celli L, Morrey BF, editors. Treatment of elbow lesions. Milano: Spinger; 2008. p. 281–97.CrossRefGoogle Scholar
  2. 2.
    Spinner M. Management of nerve compression lesions of the upper extremity. In: Omer GE, Spinner M, editors. Management of peripheral nerve problems. WB Saunders: Philadelphia; 1980. p. 569–87.Google Scholar
  3. 3.
    Dang AC, Rodner CM. Unusual compression neuropathies of the forearm, part I: radial nerve. J Hand Surg. 2009;34A:1906–14.CrossRefGoogle Scholar
  4. 4.
    Van den Ende KI, Steinmann SP. Radial tunnel syndrome. J Hand Surg [Am]. 2010;35:1004–6.CrossRefGoogle Scholar
  5. 5.
    Leclère FM, Bignion D, Franz T, Mathys L, Vögelin E. Endoscopically assisted nerve decompression of rare nerve compression syndromes at the upper extremity. Arch Orthop Trauma Surg. 2013;133:575–82.CrossRefGoogle Scholar
  6. 6.
    Leclère FM, Bignion D, Franz T, Mathys L, Klimsa C, Vögelin E. Endoscopically assisted proximal radial nerve decompression: surgical technique. Neurochirurgie. 2015;61(1):30–4.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Esther Vögelin
    • 1
    Email author
  • Dietmar Bignion
    • 1
  • Franck Leclère
    • 1
  • Celli Andrea
    • 2
  • Bonucci PierLuigi
    • 2
  • de Luise Guglielmo
    • 2
  1. 1.Department of Plastic and Hand SurgeryUniversity of Bern, InselspitalBernSwitzerland
  2. 2.Department of Orthopaedic, Shoulder and Elbow UnitHesperia HospitalModenaItaly

Personalised recommendations