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RADIAL NERVE INJURIES

Keywords: radial nerve injury , wrist drop , nerve conduction study , electromyography , neuraprexia , axonotmesis , neurotmesis

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Abstract:

Objective: To highlight etiological factors leading to radial nerve injury resulting in wrist drop, withparticular reference to iatrogenic causes. Design: Retrospection & Descriptive. Material & Methods: One hundredpatients of all ages and both sexes with wrist drop. Data of clinical assessment after detailed history and examinationas well as electro diagnostic studies was recorded on pre-designed assessment proforma. The outcome was charteddown for frequency of etiology of the wrist drop. Setting: Rehabilitation Medicine Department of Combined MilitaryHospital (CMH) Multan and Armed Forces Institute of Rehabilitation Medicine (AFIRM). Results: The major cause ofinjury was splinter/gun shot injury 31%, mis-placed injection at mid-arm 21%fracture of humerus was 21%, compressionneuropathy 16%, and stab wound 11% caused wrist drop. Electro-physiological studies revealed that 85% patients hadinjury to radial nerve at mid-arm, 9% had injury to posterior interosseous nerve while 4% had injury to superficial branchof radial nerve and only 2% had normal study. Electrodiagnostic studies also revealed that majority of the patientssuffered from axonotmesis (44%) and neurapraxia (38%), whereas (16%) were neurotmesis. Conclusion: The mostcommon cause of radial nerve injury is trauma. It is also found that the frequency of radial nerve palsy due to iatrogeniccauses is quite high. In addition to the clinical examination, the nerve conduction studies and electromyography provedto be the better investigation technique in the assessment of the location, severity and extent of the peripheral nerveinjury and subsequently guides in starting the proper treatment option due to early referral of patient to the concernedfields.

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