Elsevier

The Journal of Hand Surgery

Volume 34, Issue 10, December 2009, Pages 1906-1914
The Journal of Hand Surgery

Current concept
Unusual Compression Neuropathies of the Forearm, Part I: Radial Nerve

https://doi.org/10.1016/j.jhsa.2009.10.016Get rights and content

Peripheral compression neuropathies are familiar to the hand surgeon. Although compression neuropathies of the forearm are far less common than those of the wrist (namely, carpal tunnel syndrome), for the patient suffering from one of these neuropathies, a missed diagnosis has far-reaching consequences. In this 2-part review (I: Radial Nerve; II: Median Nerve), several compression neuropathies of the forearm are examined. We will first discuss compression neuropathies affecting the radial nerve: (1) posterior interosseous nerve syndrome, (2) radial tunnel syndrome, and (3) superficial radial nerve compression (Wartenberg's syndrome).

Section snippets

Compression Syndromes of the Posterior Interosseous Nerve

The PIN is thought of as a “motor-only” nerve that travels through the radial tunnel. The radial tunnel is a potential space 3 to 4 finger breadths long, lying along the anterior aspect of the proximal radius through which the PIN travels. The floor of the radial tunnel is created by the capsule of the radiocapitellar joint, which continues as the deep head of the supinator muscle. Anatomically, there are 5 potential sites of compression of the PIN in the area of the radial tunnel: (1) fibrous

Compression of the Superficial Radial Nerve (SRN)

The SRN is the superficial sensory branch of the radial nerve. After the radial nerve bifurcates into the SRN and PIN, the SRN courses distally into the forearm deep to the brachioradialis. Approximately 9 cm proximal to the radial styloid, the SRN becomes a subcutaneous structure by traveling between the brachioradialis and ECRL tendons (Fig. 2).74 The SRN continues to travel in the subcutaneous tissues and branches out into dorsal digital nerves responsible for afferent sensory input from the

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