Radial nerve palsy following traumatic humeral diaphyseal fractures occurs uncommonly. Most recover with good outcome. However the cases with poor outcome or recovery will have tendon transfers to regain the lost functions. Various tendon transfer methods and choices are available in literatures citing acceptable to good results. We report a case of radial nerve transection secondary to a closed traumatic diaphyseal fracture of the humerus which did not improve despite the repair. As many conventional technique produce asynergistic muscle action with secondary post-transfer deformity, thus we had resorted to tendon transfer procedure using an unconventional donor and recipient tendons yielding good results. This new combination of tendon transfers was invented involves better dynamic correlation of synergistic muscles action and produces good outcome and hand function.
Radial Nerve

The supracondylar humerus fracture (SCHF) in children is common and can be complicated with nerve injury either primarily immediate post-trauma or secondarily posttreatment. The concept of neurapraxic nerve injury makes most surgeons choose to ‘watch and see’ the nerve recovery before deciding second surgery if the nerve does not recover. We report three cases of nerve injury in SCHF, all of which underwent nerve exploration for different reasons. Early reduction in the Casualty is important to release the nerve tension before transferring the patient to the operation room. If close reduction fails, we proceed to explore the nerve together with open reduction of the fracture. In iatrogenic nerve injury, we recommend nerve exploration to determine the surgical procedure that is causing the injury. Primary nerve exploration will allow early assessment of the injured nerve and minimize subsequent surgery.
Radial Nerve ; Ulnar Nerve

No abstract available.
Paralysis* ; Radial Nerve*

Neurostenalgia is a neuropathic pain that results from continuing irritation of an anatomically intact nerve by a noxious agent. The pain resolves promptly after surgical release of the nerve. The authors report a case of neurostenalgia of the radial nerve in which the posterior interosseous branch was compressed at the arcade of Frohse, presenting with severe arm and elbow pain. The pain was immediately relieved after surgical release of the nerve.
Arm ; Elbow ; Neuralgia ; Radial Nerve*

Sometimes serious tension occurs in the radial nerve when doing internal fixation for distal humerus shaft fracture or neurorrhaphy for radial nerve injury. Medial transposition of radial nerve on fracture site can avoid direct radial nerve injury by fracture fragment, radial nerve tension by plating for distal humerus shaft fracture, and also safe from neural tension during neurorrhaphy of damaged radial nerve. We reported here total 6 cases of backward transposition of radial nerve including 2 cases of radial nerve injury associated with humerus fracture and 4 cases of comminuted fracture of humerus shaft.
Fractures, Comminuted ; Humerus ; Radial Nerve

OBJECTIVE: To investigate the possibility of volume conduction in the superficial radial sensory nerve conduction study in patients with a complete radial nerve injury. METHOD: In patients with a complete radial neuropathy, a superficial radial sensory nerve conduction study was carried out by an antidromic and orthodromic methods. Antidromic technique was carried out by increasing stimulus intensity gradually. Median palmar cutaneous nerve conduction study was also carried out by an antidromic method. RESULTS: When the stimulus intensity was significantly higher than the optimal technique, a median palmar cutaneous nerve action potential was evoked instead of the superficial radial nerve action potential. This is a volume conducting potential which occurrs following a high intensity stimulus. CONCLUSION: Superficial radial sensory conduction study must be carried out by an optimal stimulus intensity and an orthodromic method to eliminate the effect of volume conduction.
Action Potentials ; Humans ; Neural Conduction* ; Radial Nerve ; Radial Neuropathy

The authors reported the one case of posterior interosseous nerve syndrome, which had been operated and shown the good result. The posterior interosseous nerve syndrome is a neuropathy of deep musclar branch of the radial nerve. This nerve can be compressed by tumors, ganglia, elbow synovitis, or by a spontaneous compression that may occur at the point of passage through the 'arcade of Frohse'. This case had shown the vascular leash constricting the posterior interosseous nerve justproximal to the arcadet of Frohse, and the nerve below the constriction was atrophied. We reviewed other cases from the iterature in view of clinical features and management.
Constriction ; Elbow ; Ganglia ; Radial Nerve ; Synovitis

Most textbooks describe the brachialis muscle is innervated by the musculocutaneous and radial nerves. This study was performed to clarify the incidence and morphology of the branch of the radial nerve to the brachialis muscle. Eighty sides of 40 adult Korean cadavers were used in this study. The incidence of the radial nerve to the brachialis muscle was 75% of 80 sides and the radial nerve was innervated bilaterally in 65% (26 sides). The number of the branch arising from the radial nerve was one (65%), two (31.7%) or three (3.3%). The average distance from the lateral epicondyle to the branch arising from the radial nerve was 68.5 mm (range: 4 ~126 mm). The brachialis muscle received a branch from radial nerve, through a descending branch (58.5%), a transverse branch (26.8%) or an ascending branch (14.6%). A branch of the radial nerve was usually divided into one or two branches (79.3%) before piecing the brachialis muscle. The average distance from the lateral epicondyle to the perforating point of the branch was 52.4 mm (range: 3 ~123 mm). The branch of the radial nerve penetrated inferior and middle third of the brachialis muscle in 44.2% and 53.2% respectively.
Adult ; Cadaver ; Humans ; Incidence ; Radial Nerve*

No abstract available.
Paralysis* ; Radial Nerve* ; Tendon Transfer* ; Tendons*

Authors presented the experience of Ender nail treatment for the humeral shaft fractures in 24 patients. The results of treatment in all were satisfactory, though there were four cases of delayed union. Bridging callus was formed at 8.2 weeks on an average. The average clinical union time was 14 weeks. No complications developed during nailing procedure. A case of radial nerve palsy after fracture recovered spontaneously. Longer nails which hit the end of medullary canal of distal fragment distracted the fracture gap, and resulted in delayed union in 4 cases. Therefore, it is recommended to use the proper size of nail to avoid the distraction effect of the inserted nail, and to use two nails at minimum for better fixation. However, when intramedullary Ender nailing is properly done, single nailing also can give consistently good anatomic and functional results.
Bony Callus ; Humans ; Humerus ; Paralysis ; Radial Nerve