Compression Neuropathies
Gary W. Jay in Practical Guide to Chronic Pain Syndromes, 2016
This motor syndrome is variably the result of tendinous hypertrophy of the arcade of Frohse and the thickening of the radiocapitellar joint capsule. Vascular compression of the artery of Henry (from the recurrent radial artery) has been described. Repetitive supination motion injury from work activities or from crutches pressing on the supinator muscle may contribute to the condition. The symptoms include a progression of paresis of the extensors of the MCP joints, resulting variably in LOS of the finger extensors and of the thumb abductors. Pain may radiate to the neck and shoulder. Clinical testing for this syndrome may proceed as follows: (a) palpation over the PIN under the supinator muscle may elicit pain; (b) the Tinnel sign, tapping over the radial head immediately distal to the lateral epicondyle, may produce tingling along the radial nerve; (c) passive stretching of the third digit may reproduce pain. EMG studies did not show consistent results. Management of the condition is mainly protective and preventive. Rest and gentle exercise may speed recovery. Anesthetic/steroid injections may offer symptomatic relief. Surgery has been successful in fewer than 50% of cases (35,39).
The Articulations of the Upper Member
Gene L. Colborn, David B. Lause in Musculoskeletal Anatomy, 2009
Again identify the common interosseous artery and its posterior interosseous branch. Note the course of the deep branch of the radial nerve as it passes into, and through, the supinator muscle. Divide the biceps, brachialis and triceps at their insertions and reflect them away from the elbow. Also reflext the anconeus toward its ulnar insertion. Pronate and supinate the forearm to demonstrate the functions of the proximal and distal radio-ulnar joints.
Injuries of the Forearm and Wrist
Louis Solomon, David Warwick, Selvadurai Nayagam in Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Nerve injuries are rarely caused by the fracture, but they may be caused by the surgeon! Exposure of the radius in its proximal third risks damage to the posterior interosseous nerve where it is covered by the superficial part of the supinator muscle. Surgical technique is particularly important here; the anterior Henry approach is safest to protect the nerve.
Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion
Published in Physiotherapy Theory and Practice, 2021
Gyeong-Tae Gwak, Ui-Jae Hwang, Sung-Hoon Jung, Jun-Hee Kim, Moon-Hwan Kim, Oh-Yun Kwon
It has been recommended that forearm supination torque and range of motion be assessed in an elbow-flexed position (Reese and Bandy, 2016; Santos, Pauchard, and Guilloteau, 2017; Wong and Moskovitz, 2010). However, Shaaban, Pereira, Williams, and Lees (2008) reported that both pronation and supination range of motion are related to elbow position (flexed or extended). The results of their study showed that greater elbow flexion range of motion was associated with an increase in forearm supination. Furthermore, the forearm supinators are differentially affected by different elbow positions (Muscolino, 2016). The primary forearm supinators are the supinator muscle and the biceps brachii. The recruitment of the supinator muscle during forearm rotation is not influenced by elbow position (Bremer, Sennwald, Favre, and Jacob, 2006; Kisner and Colby, 2012). However, the biceps brachii is normally recruited during higher power supination activities in an elbow-flexed position (Hale, Dorman, and Gonzalez, 2011). Therefore, the elbow position seems to be important when assessing the function of the forearm supinators (Kendall, McCreary, and Provance, 2010; Kisner and Colby, 2012).
Effect of dry needling on radial tunnel syndrome: A case report
Published in Physiotherapy Theory and Practice, 2019
Sudarshan Anandkumar
On palpation, tenderness was elicited over the right supinator muscle 4.5 cm below the right lateral epicondyle, which reproduced the patient’s concordant symptom (Figure 2). Palpation over the common extensors, anconeus, brachialis, biceps, brachioradialis, and triceps did not reproduce the patient’s symptoms. Range of motion testing and assessment of end feel were normal for the cervical spine, thoracic spine, shoulder complex, elbow, forearm, wrist, and hand; however, the patient felt severe discomfort at the elbow during passive pronation, which reproduced his symptoms. Resisted isometrics to the wrist flexors, wrist extensors, elbow flexors, and elbow extensors were strong and pain-free. Though resisted middle finger extension was painless, resisted supination reproduced the patient’s symptoms exacerbating the radiating pain down the forearm. Manual muscle testing of the upper quarter did not reveal any motor weakness.
Stimulated biofeedback training for a child with Becker muscular dystrophy and compartment syndrome in the left forearm
Published in Physiotherapy Theory and Practice, 2022
Merve Kurt, Dilan Savaş, Tülay Tarsuslu Şimşek, Uluç Yiş
NMES is an effective method for improving muscle function in patients with muscular dystrophy (Colson et al., 2010; Scott, Vrbova, Hyde, and Dubowitz, 1986). Biofeedback has been shown to improve function in different disease groups (Dursun, Dursun, and Alican, 2004; Zupan, 1992). Studies have shown that NMES and biofeedback training are effective when used alone (Scott, Vrbova, Hyde, and Dubowitz, 1986; Yoo et al., 2014). We decided to use SBT, combining both NMES and biofeedback training, to treat this child given that NMES and biofeedback methods were both reported to be potentially effective applications for patients with similar diagnoses. Both lower and upper extremities were targeted for SBT treatment. We applied the SBT to the quadriceps and tibialis anterior muscles in the lower extremities because these muscles tend to be affected first and to be weakest in BMD. In the left upper extremity, the SBT was applied to the supinator muscle because of its high impact on function, and since it was the most affected muscle from NCS based on patient complaints. As a precaution, creatine kinase, lactate dehydrogenase, and C-reactive protein were monitored initially and at six and twelve weeks by laboratory testing to ensure the safety of training.
Related Knowledge Centers
- Lateral Epicondyle of The Humerus
- Radial Tuberosity
- Tendon
- Ulna
- Humerus
- Posterior Compartment of The Forearm
- Radius
- Deep Branch of Radial Nerve
- Lateral Epicondyle of The Humerus
- Radial Collateral Ligament of Elbow Joint
- Annular Ligament of Radius