Decompression Of Radial Nerve Research Articles

Endoscopically assisted proximal radial nerve decompression: Surgical technique

State of the artThe proximal radial nerve compression syndrome includes supinator syndrome and proximal radial nerve constrictions. This article presents a new endoscopic assisted radial nerve decompression surgical technique described for the first time by Leclère et al. in 2013. Surgical techniqueEndoscopic scissor decompression of the proximal radial nerve is always performed under plexus anaesthesia. It includes 8 key steps documented in this article. We review the indications and limitations of the surgical technique. ConclusionEarly clinical results after endoscopic assisted decompression of the radial nerve appear excellent. However, they still need to be compared with conventional techniques. Clinical studies are likely to widely develop because of the mini-invasive nature of this new surgical technique.

Lateral epicondylitis treatment by extensor carpi radialis fasciotomy and radial nerve decompression: Is outcome influenced by the occupational disease compensation aspect?

The etiology, treatment, and patient management in cases of chronic epicondylitis, within the legislation on occupational disease, remain highly controversial. Recognition as an occupational disease has a negative influence on the functional result of epicondylitis treated with aponeurotomy and neurolysis of the motor branch of the radial nerve. Twenty-eight patients (30 cases of epicondylitis) were operated between January 2007 and January 2008. There were nine men and 19 women whose mean age was 46.1 years. A preoperative EMG found anomalies in the deep posterior interosseous nerve in all cases. Patients were divided into two groups: one group of patients recognized as having an occupational disease and a group of patients whose disease was not considered occupation-related. The patients were seen at follow-up at a mean 21.8 months. In the group of patients with occupational disease, there were six excellent, nine good, and five acceptable results; in the second group, there were six excellent, two good, and two acceptable results. Recognition of epicondylitis as an occupational disease has a significant influence only on the time to pain relief and the result on strength. Level IV. Retrospective study.

Results of surgical treatment for radial tunnel syndrome.

We reviewed the outcome of radial nerve decompression in 28 patients with an average 28-month follow-up period. The outcome was determined by both subjective (ie, questionnaire) and objective assessments. Only 11 of the 28 patients (39%) had excellent or good results. However, 64% subjectively assessed their results as excellent or good. Results were worse in patients receiving workers' compensation or who were in litigation. The difference was statistically significant. Although previous studies have found a high rate of good results, we believe that a high rate of morbidity is associated with both the disease and its treatment. Based on our results we suggest that great caution be taken before performing radial tunnel release and strict adherence to the indications noted during the preoperative examination.

Differential latency testing: A more sensitive test for radial tunnel syndrome

A modification of the standard electrodiagnostic test was developed in an effort to provide a more sensitive electrodiagnostic evaluation in radial tunnel syndrome. Radial motor nerve latency recordings were obtained in 3 different forearm positions: neutral, passive supination, and passive pronation. The maximal difference in these recordings, the differential latency, in 25 patients with radial tunnel syndrome of greater than 6 months duration (test group) was compared with those in 25 asymptomatic volunteers (control group). Differential latency recordings were obtained in all patients in the test group before and after surgery. Radial nerves that were compressed demonstrated a significantly greater differential latency (0.44+/-0.12 ms) versus controls (0.12+/-0.008 ms). Following radial nerve decompression, differential motor latencies in the test group decreased below control values, demonstrating a resolution of the provoked electrical response with a postoperative differential latency of 0.07+/-0.05 ms. Our results demonstrate the differential motor latency of the radial nerve to be a sensitive electrodiagnostic tool in patients with radial tunnel syndrome. A differential latency of > or =0.30 ms was considered indicative of radial tunnel syndrome.