Journal List > Arch Hand Microsurg > v.24(3) > 1143552

Kang, Baek, Suh, Park, Kim, and Park: Radial Nerve Torsion: A Case Report

Abstract

Peripheral nerve torsion is a rare cause of peripheral nerve palsy and its etiology is also unknown. It is usually misdiagnosed as compressive neuropathy or radiculopathy of spine though the treatment and clinical result are different from them. Authors present a case of radial nerve torsion. The symptom was same with a posterior interosseous nerve syndrome. However, the lesion is located not at forearm but at arm.

Figures and Tables

Fig. 1

The patient presented with left finger drop.

ahm-24-285-g001
Fig. 2

(A) Ultrasonography and (B) magnetic resonance imaging showed hourglass-like constriction at the arm.

ahm-24-285-g002
Fig. 3

Microscopic photographs during surgical exploration at the arm. (A) Superficial and deep branch of radial nerve could be distinguished each other and the superficial branch climbed over the deep branch. (B) Nerve erythema and adhesion were found in the proximal portion of torsion. (C) After incising nerve sheath, the deep branch which was twisted about 180 degrees was found. (D) Epineural neurorrhaphy was performed after torsion resection. Proximal portion is to the right, black arrowheads: nerve torsion, thick white arrows: deep branch of radial nerve, thin white arrows: superficial branch of radial nerve, black arrows: interconnection between superficial and deep branch of radial nerve containing motor branch to brachioradialis, extensor carpi radialis longus and extensor carpi radialis brevis muscle.

ahm-24-285-g003

Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

References

1. Guerra WK, Schroeder HW. Peripheral nerve palsy by torsional nerve injury. Neurosurgery. 2011; 68:1018–1024. discussion 1024.
crossref
2. Kollmer J, Preisser P, Bendszus M, Kele H. Fascicular torsions of the anterior and posterior interosseous nerve in 4 cases: neuroimaging methods to improve diagnosis. J Neurosurg. 2019; DOI: 10.3171/2019.3.JNS183302. [Epub ahead of print].
crossref
3. Burns J, Lister GD. Localized constrictive radial neuropathy in the absence of extrinsic compression: three cases. J Hand Surg Am. 1984; 9A:99–103.
crossref
4. Yongwei P, Guanglei T, Jianing W, Shuhuan W, Qingtai L, Wen T. Nontraumatic paralysis of the radial nerve with multiple constrictions. J Hand Surg Am. 2003; 28:199–205.
crossref
5. Qi HT, Wang XM, Li SY, et al. The role of ultrasonography and MRI in patients with non-traumatic nerve fascicle torsion of the upper extremity. Clin Radiol. 2013; 68:e479–e483.
crossref
6. Bäumer P, Kele H, Xia A, et al. Posterior interosseous neuropathy: Supinator syndrome vs fascicular radial neuropathy. Neurology. 2016; 87:1884–1891.
TOOLS
ORCID iDs

Jong Woong Park
https://orcid.org/0000-0003-2751-2519

Similar articles