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Deep Branch of the Radial Nerve Entrapment

  • Chapter
Peripheral Nerve Entrapments

Abstract

Entrapment of the deep branch of the radial nerve (DBRN) leads to one of two distinct clinical syndromes. Posterior interosseous nerve syndrome (PINS) is a well-defined, rare, and fairly painless nerve palsy involving some of the wrist extensors and all of the finger extensors. By contrast, radial tunnel syndrome (RTS) is a painful repetitive stress type of injury without “hard” neurologic symptoms. Most of the focus of this chapter will be on RTS, a more commonly diagnosed but more controversial disorder in musculoskeletal practice.

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References

  1. Dang AC, Rodner CM. Unusual compression neuropathies of the forearm. part I: radial nerve. J Hand Surg [Am]. 2009;34(10):1906–14.

    Article  Google Scholar 

  2. Huisstede BM, Miedema HS, van Opstal T, de Ronde MT, Kuiper JI, Verhaar JA, et al. Interventions for treating the posterior interosseus nerve syndrome: a systematic review of observational studies. J Peripher Nerv Syst. 2006;11(2):101–10.

    Article  PubMed  Google Scholar 

  3. Roles NC, Maudsley RH. Radial tunnel syndrome. J Bone Joint Surg Am. 1972;4B:784–90.

    Google Scholar 

  4. Sarris IK, Papadimitriou NG, Sotereanos DG. Radial tunnel syndrome. Tech Hand Up Extrem Surg. 2002;6(4):209–12.

    Article  PubMed  Google Scholar 

  5. Huisstede B, Miedema HS, van Opstal T, de Ronde MT, Verhaar JA, Koes BW. Interventions for treating the radial tunnel syndrome: a systematic review of observational studies. J Hand Surg [Am]. 2008;33(1):72–8.

    Article  Google Scholar 

  6. Naam NH, Nemani S. Radial tunnel syndrome. Orthop Clin N Am. 2012;43(4):529–36.

    Article  Google Scholar 

  7. Latinovic R, Gulliford MC, Hughes RA. Incidence of common compressive neuropathies in primary care. J Neurol Neurosurg Psychiatry. 2006;77(2):263–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Roquelaure Y, Raimbeau G, Dano C, Martin YH, Pelier-Cady MC, Mechali S, et al. Occupational risk factors for radial tunnel syndrome in industrial workers. Scand J Work Environ Health. 2000;26(6):507–13.

    Article  CAS  PubMed  Google Scholar 

  9. Keefe DT, Lintner DM. Nerve injuries in the throwing elbow. Clin Sports Med. 2004;23(4):723–42.

    Article  PubMed  Google Scholar 

  10. Martinoli C, Bianchi S, Pugliese F, Bacigalupo L, Gauglio C, Valle M, et al. Sonography of entrapment neuropathies in the upper limb (wrist excluded). J Clin Ultrasound. 2004;32(9):438–50.

    Article  PubMed  Google Scholar 

  11. Bodner G, Harpf C, Meirer R, Gardetto A, Kovacs P, Gruber H. Ultrasonographic appearance of supinator syndrome. J Ultrasound Med. 2002;21(11):1289–93.

    Article  PubMed  Google Scholar 

  12. Wang LH, Weiss MD. Anatomical, clinical, and electrodiagnostic features of radial neuropathies. Phys Med Rehabil Clin N Am. 2013;24(1):33–47.

    Article  CAS  PubMed  Google Scholar 

  13. Lawrence T, Mobbs P, Fortems Y, Stanley JK. Radial tunnel syndrome. A retrospective review of 30 decompressions of the radial nerve. J Hand Surg (Br). 1995;20(4):454–9.

    Article  CAS  Google Scholar 

  14. Riffaud L, Morandi X, Godey B, Brassier G, Guegan Y, Darnault P, et al. Anatomic bases for the compression and neurolysis of the deep branch of the radial nerve in the radial tunnel. Surg Radiol Anat. 1999;21(4):229–33.

    Article  CAS  PubMed  Google Scholar 

  15. Cravens G, Kline DG. Posterior interosseous nerve palsies. Neurosurgery. 1990;27(3):397–402.

    Article  CAS  PubMed  Google Scholar 

  16. Tubbs RS, Salter EG, Wellons 3rd JC, Blount JP, Oakes WJ. Superficial surgical landmarks for identifying the posterior interosseous nerve. J Neurosurg. 2006;104(5):796–9.

    Article  PubMed  Google Scholar 

  17. Khan R, Birch R. Iatropathic injuries of peripheral nerves. J Bone Joint Surg (Br). 2001;83(8):1145–8.

    Article  CAS  Google Scholar 

  18. Ferdinand BD, Rosenberg ZS, Schweitzer ME, Stuchin SA, Jazrawi LM, Lenzo SR, et al. MR imaging features of radial tunnel syndrome: initial experience. Radiology. 2006;240(1):161–8.

    Article  PubMed  Google Scholar 

  19. Tubbs RS, Apaydin N, Uz A, Sullivan A, Loukas M, Shoja MM, et al. Anatomy of the lateral intermuscular septum of the arm and its relationships to the radial nerve and its proximal branches. Laboratory investigation. J Neurosurg. 2009;111(2):336–9.

    Article  PubMed  Google Scholar 

  20. Van de Pol GJ, Koudstaal MJ, Schuurman AH. Bleys RL Innervation of the wrist joint and surgical perspectives of denervation. J Hand Surg [Am]. 2006;31(1):28–34.

    Article  Google Scholar 

  21. Dellon AL, Seif SS. Anatomic dissections relating the posterior interosseous nerve to the carpus, and the etiology of dorsal wrist ganglion pain. J Hand Surg [Am]. 1978;3(4):326–32.

    Article  CAS  Google Scholar 

  22. Abrams RA, Ziets RJ, Lieber RL, Botte MJ. Anatomy of the radial nerve motor branches in the forearm. J Hand Surg [Am]. 1997;22(2):232–7.

    Article  CAS  Google Scholar 

  23. Clavert P, Lutz JC, Adam P, Wolfram-Gabel R, Liverneaux P, Kahn JL. Frohse’s arcade is not the exclusive compression site of the radial nerve in its tunnel. Orthop Traumatol Surg Res. 2009;95(2):114–8.

    Article  CAS  PubMed  Google Scholar 

  24. Ozkan M, Bacakoglu AK, Gul O, Ekin A, Magden O. Anatomic study of posterior interosseous nerve in the arcade of Frohse. J Shoulder Elbow Surg. 1999;8(6):617–20.

    Article  CAS  PubMed  Google Scholar 

  25. Hazani R, Engineer NJ, Mowlavi A, Neumeister M, Lee WP, Wilhelmi BJ. Anatomic landmarks for the radial tunnel. Eplasty. 2008;8, e37.

    PubMed  PubMed Central  Google Scholar 

  26. Spinner M. The arcade of Frohse and its relationship to posterior interosseous nerve paralysis. J Bone Joint Surg (Br). 1968;50(4):809–12.

    CAS  Google Scholar 

  27. Jones JA, Jones CM, Grossman MG. Effect of elbow flexion on the proximity of the PIN during 2-incision distal biceps repair. Orthopedics. 2013;36(7):e931–5.

    Article  PubMed  Google Scholar 

  28. Berton C, Wavreille G, Lecomte F, Miletic B, Kim HJ. Fontaine C The supinator muscle: anatomical bases for deep branch of the radial nerve entrapment. Surg Radiol Anat. 2013;35(3):217–24.

    Article  PubMed  Google Scholar 

  29. Prasartritha T, Liupolvanish P, Rojanakit A. A study of the posterior interosseous nerve (PIN) and the radial tunnel in 30 Thai cadavers. J Hand Surg [Am]. 1993;18(1):107–12.

    Article  CAS  Google Scholar 

  30. Brabston EW, Genuario JW, Bell JE. Anatomy and physical examination of the elbow. Oper Tech Orthop. 2009;19(4):190–8.

    Article  Google Scholar 

  31. Werner CO, Haeffner F, Rosen I. Direct recording of local pressure in the radial tunnel during passive stretch and active contraction of the supinator muscle. Arch Orthop Trauma Surg. 1980;96(4):299–301.

    Article  CAS  PubMed  Google Scholar 

  32. Rose NE, Forman SK, Dellon AL. Denervation of the lateral humeral epicondyle for treatment of chronic lateral epicondylitis. J Hand Surg [Am]. 2013;38(2):344–9.

    Article  Google Scholar 

  33. Woodward TW, Best TM. The painful shoulder: part I. Clinical evaluation. Am Fam Physician. 2000;61(10):3079–88.

    CAS  PubMed  Google Scholar 

  34. Chien AJ, Jamadar DA, Jacobson JA, Hayes CW, Louis DS. Sonography and MR imaging of posterior interosseous nerve syndrome with surgical correlation. AJR Am J Roentgenol. 2003;181(1):219–21.

    Article  PubMed  Google Scholar 

  35. Furuta T, et al. Magnetic resonance microscopy imaging of posterior interosseous nerve palsy. Jpn J Radiol. 2009;27(1):41–4.

    Article  PubMed  Google Scholar 

  36. Rinkel WD, Schreuders TA, Koes BW, Huisstede BM. Current evidence for effectiveness of interventions for cubital tunnel syndrome, radial tunnel syndrome, instability, or bursitis of the elbow: a systematic review. Clin J Pain. 2013;29(12):1087–96.

    Article  PubMed  Google Scholar 

  37. van den Ende KI, Steinmann SP. Radial tunnel syndrome. J Hand Surg [Am]. 2010;35(6):1004–6.

    Article  Google Scholar 

  38. van Rijn RM, Huisstede BM, Koes BW, Burdorf A. Associations between work-related factors and specific disorders at the elbow: a systematic literature review. Rheumatology (Oxford). 2009;48(5):528–36.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Seattle Spine and Sports Medicine, 3213 Eastlake Ave East, Seattle, WA, 98102, USA

    Richard E. Seroussi MD, MSc

  2. Department of Rehabilitation Medicine, Courtesy Clinical Faculty, University of Washington, Seattle, WA, USA

    Richard E. Seroussi MD, MSc

  3. Clinical Faculty, Department of Rehabilitation Medicine, University of Washington, Seattle Spine and Sports Medicine, Seattle, WA, USA

    Virtaj Singh MD

  4. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA

    Helen W. Karl MD

Authors
  1. Richard E. Seroussi MD, MSc
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  2. Virtaj Singh MD
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  3. Helen W. Karl MD
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Corresponding author

Correspondence to Richard E. Seroussi MD, MSc .

Editor information

Editors and Affiliations

  1. Pain and Headache Center, Anchorage, AK, USA

    Andrea M. Trescot MD, ABIPP, FIPP (Medical Director) (Medical Director)

Electronic Supplementary Material

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Physical exam of the radial nerve at the elbow (MOV 37274 kb)

Landmark-guided injection of the radial nerve at the elbow (MOV 38763 kb)

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Seroussi, R.E., Singh, V., Karl, H.W. (2016). Deep Branch of the Radial Nerve Entrapment. In: Trescot, A.M. (eds) Peripheral Nerve Entrapments. Springer, Cham. https://doi.org/10.1007/978-3-319-27482-9_35

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  • DOI: https://doi.org/10.1007/978-3-319-27482-9_35

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27480-5

  • Online ISBN: 978-3-319-27482-9

  • eBook Packages: MedicineMedicine (R0)

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