• Title/Summary/Keyword: radial nerve

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Results of the Autogenous Sural Nerve Graft for Ruptured Radial Nerve in the Closed Humerus Shaft Fracture (상완골 골절과 동반된 요골 신경 손상에서 자가 비복 신경 이식술의 결과)

  • Lee, Jun-Mo;Lim, Young-Jin;Park, Jong-Hyuk
    • Archives of Reconstructive Microsurgery
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    • v.14 no.2
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    • pp.138-143
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    • 2005
  • In the high radial nerve palsy caused by displaced humeral shaft fracture, radial nerve have to be explored in the fracture site. 5 cases of the ruptured radial nerve at the fracture site of the humerus from January 1993 through January 2005 were treated at first by open reduction and internal fixation with plates and screws fixation and then defective radial nerves were grafted with autogenous sural nerves by microsurgical epineurial and or perineurial neurorrhaphy. At average 30.4 months follow-up, 5 cases were recovered from motor and sensory deficit with solid bony union of the humerus shaft fracture. Authors have confirmed that ruptured radial nerve in the humerus shaft fracture grafted with autogenous sural nerve with microsurgical epineurial and or perineurial neurorrhaphy would be expected good motor and sensory recovery.

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Compression of the Superficial Radial Nerve by Schwannoma: A Case Report (신경초종에 의한 표재요골신경의 압박)

  • Kim, Hyun-Sung;Kim, Chul-Han;Kang, Sang-Gue;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.494-497
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    • 2011
  • Purpose: Schwannoma, a benign peripheral nerve tumor, is slow-growing, encapsulated neoplasm that originates from the Schwann cell of the nerve sheath. Schwannoma most frequently involves the major nerve. Schwannoma occurring in the superficial radial nerve rare. This is a report of our experience with schwannoma arising from the superficial radial nerve with neurologic symptom. Methods: A 55-year-old woman presented with eight-month history of progressive numbness and paresthesia in dorsum of the thumb and index finger. Physical examination revealed a localized mass on the midforearm. Sonographic examination showed an ovoid, heterogenous, hypoechoic lesion, located eccentrically in related to the superficial radial nerve. The lesion was mobile in the transverse but not in the longitudinal axis of the nerve, which was thought to favour schwannoma rather than neurofibroma. At operation, a $20{\times}15mm$ ovoid, yellowish grey mass was seen arising from the superficial radial nerve. The tumor present as eccentric masses over which the nerve fibers are splayed. Using operating microscope, the tumor was removed, preserving the surrounding nerve. Results: Histology confirmed that the mass was a benign schwannoma. There were no postoperative complications. After two months the patient had no clinically demonstrable sensory deficit. Conclusion: An unsusual case of a schwannoma of the superficial radial nerve is presented. In case with neurologic symptom, prompt surgical decompression must be made to prevent further nerve damage and to restore nerve function early.

Anatomy of Large Intestine Meridian Muscle in human (수양명경근(手陽明經筋)의 해부학적(解剖學的) 고찰(考察))

  • Sim Young;Park Kyoung-Sik;Lee Joon-Moo
    • Korean Journal of Acupuncture
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    • v.19 no.1
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    • pp.15-23
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    • 2002
  • This study was carried to identify the component of Large Intestine Meridian Muscle in human, dividing into outer, middle, and inner part. Brachium and antebrachium were opened widely to demonstrate muscles, nerve, blood vessels and the others, displaying the inner structure of Large Intestine Meridian Muscle. We obtained the results as follows; 1. Meridian Muscle is composed of the muscle, nerve and blood vessels. 2. In human anatomy, it is present the difference between a term of nerve or blood vessels which control the muscle of Meridian Muscle and those which pass near by Meridian Muscle. 3. The inner composition of meridian muscle in human arm is as follows. 1) Muscle; extensor digitorum tendon(LI-1), lumbrical tendon(LI-2), 1st dosal interosseous muscle(LI-3), 1st dosal interosseous muscle and adductor pollicis muscle(LI-4), extensor pollicis longus tendon and extensor pollicis brevis tendon(LI-5), adductor pollicis longus muscle and extensor carpi radialis brevis tendon(LI-6), extensor digitorum muscle and extensor carpi radialis brevis mucsle and abductor pollicis longus muscle(LI-7), extensor carpi radialis brevis muscle and pronator teres muscle(LI-8), extensor carpi radialis brevis muscle and supinator muscle(LI-9), extensor carpi radialis longus muscle and extensor carpi radialis brevis muscle and supinator muscle(LI-10), brachioradialis muscle(LI-11), triceps brachii muscle and brachioradialis muscle(LI-12), brachioradialis muscle and brachialis muscle(LI-13), deltoid muscle(LI-14, LI-15), trapezius muscle and supraspinous muscle(LI-16), platysma muscle and sternocleidomastoid muscle and scalenous muscle(LI-17, LI-18), orbicularis oris superior muscle(LI-19, LI-20) 2) Nerve; superficial branch of radial nerve and branch of median nerve(LI-1, LI-2, LI-3), superficial branch of radial nerve and branch of median nerve and branch of ulna nerve(LI-4), superficial branch of radial nerve(LI-5), branch of radial nerve(LI-6), posterior antebrachial cutaneous nerve and branch of radial nerve(LI-7), posterior antebrachial cutaneous nerve(LI-8), posterior antebrachial cutaneous nerve and radial nerve(LI-9, LI-12), lateral antebrachial cutaneous nerve and deep branch of radial nerve(LI-10), radial nerve(LI-11), lateral antebrachial cutaneous nerve and branch of radial nerve(LI-13), superior lateral cutaneous nerve and axillary nerve(LI-14), 1st thoracic nerve and suprascapular nerve and axillary nerve(LI-15), dosal rami of C4 and 1st thoracic nerve and suprascapular nerve(LI-16), transverse cervical nerve and supraclavicular nerve and phrenic nerve(LI-17), transverse cervical nerve and 2nd, 3rd cervical nerve and accessory nerve(LI-18), infraorbital nerve(LI-19), facial nerve and infraorbital nerve(LI-20). 3) Blood vessels; proper palmar digital artery(LI-1, LI-2), dorsal metacarpal artery and common palmar digital artery(LI-3), dorsal metacarpal artery and common palmar digital artery and branch of deep palmar aterial arch(LI-4), radial artery(LI-5), branch of posterior interosseous artery(LI-6, LI-7), radial recurrent artery(LI-11), cephalic vein and radial collateral artery(LI-13), cephalic vein and posterior circumflex humeral artery(LI-14), thoracoacromial artery and suprascapular artery and posterior circumflex humeral artery and anterior circumflex humeral artery(LI-15), transverse cervical artery and suprascapular artery(LI-16), transverse cervical artery(LI-17), SCM branch of external carotid artery(LI-18), facial artery(LI-19, LI-20)

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Compression Neuropathy of Superficial Radial nerve by Variation of Course of Radial Artery in Distal Forearm - A case report - (원위 전완부에서 요골 동맥의 주행 변이로 발생된 표재성 요골 신경 압박증 - 1례 보고 -)

  • Kim, Chong-Kwan;Ahn, Bung-Woo;Kwak, Wan-Sub;Jo, Jae-Il;Kim, Woo-Sik;Yoon, Jong-Ho
    • Archives of Reconstructive Microsurgery
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    • v.15 no.1
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    • pp.38-41
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    • 2006
  • A 57-year-old male suffered from tingling and paraesthesia on radial side of right hand. We carried out exploration, the process being done, a radial artery passing between the two branches of bifurcated superficial radial nerve was found by accident. Then we performed dissection of the radial artrery a little more distally. It was passing above the extensors of thumb to anstomical snuff box. We treated it with ligating the radial artery, which was done a little above the bifurcated site of superficial radial nerve after angiography of upper extremity. While we were following this procedure, we noticed that symptoms had improved a lot. To our knowlege, neuropathy, by itself of superficial radial nerve by the radial artery with anatomical variation has never been reported and therefore we report this case.

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Usefuless of Ultrasonography Examination in Radial Nerve Palsy Associated with Humerus Fracture - Technical Report - (상완골 골절에 동반된 요골 신경 마비 환자에서 초음파 검사의 유용성 - 술기 보고 -)

  • Lee, Sang-Hyuk;Sung, Chang-Min;Park, Hyung-Bin
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.15-21
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    • 2012
  • Primary radial nerve palsy occurs in association with approximately 10% of humerus shaft fractures. Secondary radial nerve palsy, which is iatrogenic, occurs in association with approximately 10% to 20% of humerus shaft fractures. Whether the radial nerve palsy is caused primarily by the fracture or secondarily by the surgery, it is necessary to determine whether the radial nerve is being disrupted or compressed by the surrounding structures. This evaluation will dictate whether to await natural recovery or to perform surgical exploration. The current authors report one case of primary radial nerve palsy, due to the humerus fracture, and one case of secondary radial nerve palsy, associated with the osteosynthesis procedure. In both patients, the radial nerve was assessed for anatomical integrity with ultrasonography. Nerve disruption was found in one patient, and a sural nerve graft was performed. Nerve adhesion was found in the other patient, and neurolysis was performed. In both cases, the clinical results were satisfactory. This report focuses on the usefulness of ultrasonography in radial nerve assessment in patients with radial nerve palsy.

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Nerve length measurement method in a radial motor nerve conduction study

  • Kim, Jae-Gyum;Kim, Yoohwan;Seok, Hung Youl;Kim, Byung-Jo
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.28-33
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    • 2017
  • Background: Previous studies of radial nerve conduction study (NCS) did not present how to measure the length of the radial nerve across the elbow, and did not even mention how to manage the spiral course of the nerve. This study aimed to applicate the most reliable method to measure the length of the radial nerve during NCS. Methods: Three points (A, B, and C) were determined along the relatively straight course of the radial nerve. The distance was measured using three different methods: L1) straight distance corresponding to the A-C distance, L2) sum of the distances corresponding to the A-B-C distance, L3) based on the L2, but the elbow is flexed at a $45^{\circ}$ angle. We compared the three methods of distance measurement and the calculated nerve conduction velocities (V1, V2, and V3) in normal healthy subjects. Results: 19 normal participants were enrolled. The mean value for method L1, L2 and L3 were $22.5{\pm}1.8cm$, $24.0{\pm}2.1cm$, and $23.2{\pm}2.1cm$ (p < 0.001). Calculated conduction velocities using those distance measurement methods as follows (p < 0.001): V1 ($60.9{\pm}2.7m/s$), V2 ($64.6{\pm}3.3m/s$), and V3 ($63.4{\pm}3.9m/s$). V2 was significantly greater than V1 and V3 (p < 0.001, p = 0.010, respectively). Conclusions: The distance measurement using a stopover point near the lateral epicondyle between two stimulus points in position of a fully extended elbow with forearm pronation is the most appropriate posture for radial motor NCS.

Surgical Treatment of Radial Nerve Injury (요골 신경 손상의 수술적 치료)

  • Lee, Kwang-Suk;Park, Sang-Won;Wie, Dae-Gon
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.128-136
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    • 1996
  • Radial nerve injury is caused by variety of etiologies, mainly traumatic. It is primarily a motor nerve and loss of it's function leads to a significant disability. Surgical treatments of radial nerve comprise of neurolysis(internal or external), neurorrhaphy(eineural, perineural or epi-perineural), nerve graft and tendon transfer. However, there is still controversies in treatment methods and time of operation. Authors experienced 23 cases of radial nerve injuries who were treated by operative methods and followed up over 1 year's duration. The male to female ratio was 18 to 5 and mean age was 30.7 years old. The causes were 13 cases in fractures, 5 cases in crushing injury, 3 cases in laceration, 1 case in CO poisoning and 1 case in unknown cause. The summary of the study were as follows ; 1. Excellent or good results were obtained in overall 16 cases among 23 cases; 5 of 9 cases in neurolysis, 3 of 3 cases in neurorrhaphy, 2 of 3 cases in nerve graft and 6 of 8 cases in tendon transfer. 2. In cases of neurorrhaphy and nerve graft, primary or delayed repair showed excellent or good results and neurolysis performed before 6 months leads to better results. But there was no correlations between the time of injury and operation in tendon transfer. 3. The radial nerve injury associated with extensive soft tissue defect or any conditions that leads to nerve ischemia results poor prognosis. 4. The patients aged under 40 years showed better prognosis in clinical results according to the age of surgical treatment. 5. If the surgeon decide the method and the time of operation through the exact evaluation of the factors which influencing the end result such as age of the patient, level and type of injury, extent of nerve lesion and the associated tissue injury, good result could be expected.

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Review of the Studies on Korean Medicine Treatment of Radial Nerve Palsy (요골신경마비의 한의학적 치료에 대한 연구 고찰)

  • Hyun, Jae-Cheol;Jeong, Su-Hyeon
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.2
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    • pp.43-54
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    • 2019
  • Objectives : The purpose of this study was to assess the use of Korean medicine for treating radial nerve palsy. Methods : We searched for studies on the use of Korean medicine for the treatment of radial nerve palsy in 7 electronic databases and analyzed these studies. Results : We found 95 studies on radial nerve palsy from 7 electronic databases. We excluded 77 duplicate studies, 1 review article and 2 studies published before 2000. As a result, 15 case studies(36 patients) were included. Acupuncture(15 times), electroacupuncture(6 times), pharmacopuncture(9 times), herbal medicine(11 times), physical therapy(10 times), moxibustion(3 times), cupping therapy(1 time), chuna manual therapy(1 time) and yinyang balancing appliance(1 time) were used. LI11 for acupuncture, LI4, LI11 for electroacupuncture, bee venom as pharmacopuncture material and LI4, LI10, LI11 in pharmacopuncture point, Boik-tang gami as herbal medicine, hot pack for physical therapy, LI4, LI11 for moxibustion were the most frequently used. Conclusions : Korean medicine treatment for radial nerve palsy has been performed in various ways. However, we found limited evidence regarding Korean medicine for radial nerve palsy. Thus, we think various types of studies including more case reports, for radial nerve palsy should be performed in the future.

Two Cases of Radial Nerve Palsy with Chuna Treatment on Cervical Vertebrae (경추 추나치료를 적용한 압박성 요골신경마비 환자 치험 2례)

  • Heo, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.89-96
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    • 2011
  • Objective : The purpose of this study is to evaluate the korean medical treatment for compressive neuropathy of radial nerve, especially chuna treatment of cervical vertebrae. Methods : Two patients were treated with acupuncture and moxibustion, herbal medication, chuna treatment on cervical vertebrae. To evaluate the wrist drop and numbness of hand, Coding Result of arbitrary values and manual muscle test(MMT), visual analogue scale(VAS) were used. Results : After 2 weeks-treatment(in case 1) & 5 weeks-treatment(in case 2), the movement and power of wrist were restored to nearly normal range, also the numbness of hands was removed. All cases show the improvement in the movement of wrist and the numbness of hands. Conclusions : Korean medical treatment including cervical manual therapy as chuna treatment is remarkably effective for radial nerve palsy. But further studies are required to concretely prove the effectiveness of chuna treatment on central vertebrae for peripheral neuropathy.

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Ultrasonography in Radial Nerve Palsy after Surgery of Humerus Shaft Fracture - Case Report - (상완골 간부 골절 수술 후 발생한 요골신경 마비에서 시행한 초음파 검사 -증례 보고-)

  • Yoon, Hyungmoon;Kho, Dukhwan;Kim, Hyeungjune;Nam, Kyoungmo;Kang, Daemyung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.106-112
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    • 2012
  • Radial nerve palsy after surgery of humerus fracture is uncommon complication. Occasionally it needs operative treatment because of difficulty to accurate evaluation. We report this case of radial nerve palsy after surgery of humerus shaft fracture with ultrasound examination. We checked the continuity of radial nerve and radial nerve palsy was complete recovered with conservative treatment.

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