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Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Sites of compression syndromes: Triangular space.Radial tunnel syndrome.Posterior interosseous nerve (PIN) syndrome.Wartenberg’s syndrome.Compression may occur over the humerus, related to humeral fractures, use of tourniquets or external compression (Saturday night palsy). Most resolve within 6 months.
Upper Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Because the axillary nerve only provides motor innervation for the teres minor and deltoid, it does not innervate muscles of the arm, forearm, and hand. Therefore, we are left with four nerves—musculocutaneous nerve, median nerve, ulnar nerve, and radial nerve-to provide motor inner-vation to all the muscles of these three anatomical regions (Figure 4.3). The radial nerve and its branches—the deep radial nerve, which continues as the posterior interosseous nerve—innervate all the posterior muscles of the arm and forearm, as might be expected based on their posterior location. They do not innervate muscles of the hand, because the hand has no true posterior (dorsal) intrinsic muscles, only anterior (ventral) ones, as will be explained in Section 4.2.
Test Paper 1
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Radial nerve entrapment at the elbow can be subdivided into two major categories: radial tunnel syndrome and posterior interosseous nerve syndrome. The posterior interosseous nerve is a deep branch of the radial nerve in the forearm that can be compressed from repetitive gripping combined with supination in weightlifters and swimmers. The superficial head of the supinator muscle along the arcade of Frohse is the most common site of nerve entrapment. It is important to note that a small percentage of radial neuropathy cases can be associated with tennis elbow. MRI manifestations of PIN includes thickening and increased T2-weighted signal of the nerve fibres, as well as oedema-like signal changes in the innervated extensor compartment musculature in the acute and subacute setting and atrophy in the chronic stages.
Management of posterior interosseous nerve (PIN) palsies after distal biceps tendon repair using a single incision technique- a conclusive approach to diagnostics and therapy
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Inga S. Besmens, Marco Guidi, Andreas Schiller, David Jann, Pietro Giovanoli, Maurizio Calcagni
Nerve ultrasound is a technique regularly employed in our department. It is conducted starting proximal to a suspected lesion typically at the distal upper arm following the radial nerve distally towards its division in superficial and deep branch. The deep branch is then followed through its insertion in the supinator tunnel after which by definition it is referred to as the posterior interosseous nerve. Edema and volume changes throughout the nerve’s course can visualized by ultrasound as well as a general change in nerve caliber or a continuity interruption. As Agarwal et al. pointed out technological advances in ultrasonography allow for direct visualization of the involved nerve with assessment of the exact site, extent and type of injury. It yields unmatched information about anatomical details of the nerve [10]. This way lesions to the nerve can be identified.
Brachial distal biceps injuries
Published in The Physician and Sportsmedicine, 2019
Drew Krumm, Peter Lasater, Guillaume Dumont, Travis J. Menge
The LABCN is the most commonly injured structure during both single-incision and dual-incision techniques. The nerve should be retracted laterally during each approach, as paresthesias or neuromas may develop 5–7% of time during the superficial dissection [6]. Another study by Bisson et al. showed 16% of patients with the two-incision technique had nerve complications, with the LABCN being the most common injury [26]. Injury to the radial and/or posterior interosseous nerve is more common with a single-incision approach. It has been reported in 5% of cases, most commonly due to improper retractor placement around the radial tuberosity [6]. This can be avoided by keeping the forearm fully supinated. Kelly et al. studied complications of patients undergoing the dual-incision distal bicep repair and found 4% of patients developed lateral antebrachial cutaneous paresthesias and 3% of patients had superficial radial nerve paresthesias. Furthermore, the single-incision technique resulted in a lower incidence of heterotopic ossification and synostosis compared to the dual-incision technique. Synostosis may lead to decreased pronation and supination of the forearm. This risk can be reduced by avoiding dissection between the radius and ulna and copious irrigation [27].
Radial nerve palsy following humeral shaft fracture: a theoretical PNF rehabilitation approach for tendon and nerve transfers
Published in Physiotherapy Theory and Practice, 2022
Lauren Fader, John Nyland, Hao Li, Brandon Pyle, Kei Yoshida
The radial nerve is a terminal brachial plexus posterior cord branch, receiving contributions from cervical nerve roots 5–8 and thoracic nerve root 1. The superficial radial nerve provides sensory innervation to the dorsal wrist and hand. The posterior interosseous nerve provides sequential motor innervation to the supinator, extensor carpi radialis brevis, extensor digitorum communis, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis, extensor pollicis brevis, extensor pollicis longus, and extensor indicis (Figure 1). Radial nerve injury from humerus fractures can create prolonged, severe, and often permanent disabilities (Ricci et al., 2015).