The radial nerve innervates the extensor muscles of the forearm and hand. Damage to the radial nerve causes wrist drop where the patient is unable to extend the wrist and fingers, impairing grasping. Symptoms include pain, numbness, weakness of hand grip and drooping of the wrist and fingers. Diagnosis involves assessing range of motion, imaging tests and electrodiagnostic tests. Treatment depends on the underlying cause but may include medications, injections, bracing and physical therapy.
2. Loss of radial nerve function in the hand creates a significant disability
Patient can not extend the fingers and thumb and therefore has great difficulty in
grasping objects.
Loss of active wrist extension robs grasp and power grip
3.
4. • The radial nerve is the largest branch of the brachial
plexus
• Continuation of the posterior cord, with nerve fibers
from C6, C7, C8, and,occasionally, T1.
• The radial nerve innervates the extensor and
supinator musculature located in the arm
and forearm and provides distal sensation.
5. Course
• Passes across the LD deep to the axillary artery.
• Winds around the medial side of the humerus,
• And enters the triceps muscle between the long and
medial heads.
• It follows the spiral groove of the humerus, piercing the
lateral intermuscular septum (10 cm proximal to the
lateral epicondyle) from posterior to anterior,
• Runs between the brachialis and brachioradialis to lie
anterior to the lateral condyle of the humerus.
• The nerve then divides into a superficial branch and
a deep branch.
• The superficial branch, purelysensory,
• Runs under cover of the brachioradialis in the forearm.
• Innervates the radial wrist, dorsal radial hand, and
dorsum of the radial digits
6. cousre
• The deep branch of the radial nerve, the posterior interosseous
nerve,
• winds to the dorsum of the forearm,
• around the lateral side of the radius,
• and through the muscle fibers of the supinator.
7. Motor supply
All extensor muscles:
1. Abductor pollicis longus
1. Extensor pollicis brevis
2. Extensor carpi radialis longus
3. Extensor carpi radialis brevis
4. Extensor pollicis longus
5. Extensor digitorum communis
6. Extensor indicis proprius
7. Extensor digiti minimi qui
8. Extensor carpi ulnaris
9. Lower lateral cutaneous
nerve of arm
Posterior cutaneous
nerve of arm
Posterior cutaneous
nerve of forearm
Dorsal radial sensory
nerve
Gives sensibility to the
dorsum of the hand over the
radial two-thirds, the dorsum
of the thumb, and the index,
middle finger proximal to the
distal interphalangeal joint.
Cutaneous innervation from radial nerve
10.
11.
12. sharp or burning pain
Numbness or tingling
Trouble straightening the arm
Trouble moving the wrist and fingers
Drooping of wrist and fingers
Weakness in hand grip
symptoms
13. • ROM of wrist ( to check any weakness or loss of muscle
tone)
• X-ray ,CT scan and MRI
• Electromyography
• Nerve conduction test
Diagnosis
14. Depend upon underlying cause:-
Analgesic or anti inflammatory medication
Steroid injection
Splints or braces
Physiotherapy