Radial Nerve Injury

The radial nerve runs from the armpit down the back of the arm to the hand. Surgery for radial nerve injury may include nerve repair, nerve graft, or nerve decompression.

The radial nerve is a peripheral nerve, and it is part of a network of nerves called the brachial plexus. It provides sensation and helps move the triceps, wrist, hand, and fingers.

At the Peripheral Nerve Center, we specialize in radial nerve injury and other types of nerve damage.

Symptoms

Symptoms of radial nerve injury may include pain, numbness, and/or paresthesia, especially in the middle finger, index finger, thumb, back of the hand, and/or arm. Wrist drop and finger drop may also be present.

Exact symptoms depend on the location and type of injury. In fact, careful testing of sensation and movement in the elbow, forearm, wrist, fingers, and thumb will often allow a specialist to pinpoint the site of injury.

Diagnosis

A physician tests movement and sensation in order to diagnose injury to the radial nerve.

Other tests are useful to confirm the diagnosis and seek a cause, especially if no injury is obvious.

Blood tests may be performed to look for or evaluate conditions such as diabetes, liver dysfunction, kidney dysfunction, and vitamin deficiency.

Imaging tests like MRI or ultrasound may be ordered to look for a tumor or other lesion that could be compressing the nerve.

A doctor may order electromyelography (EMG), also known as a nerve conduction study, to confirm a diagnosis of radial nerve injury and make sure other nerves are not involved.

In rare cases, a nerve biopsy may be ordered. At the Peripheral Nerve Center, we are especially experienced with nerve biopsies.

Risk Factors

The most common cause of radial nerve injury is fracture of the humerus. In such cases, nerve damage may be due to the fracture itself or to a healing callus. Other trauma to the arm—such as may occur in a sports accident or as part of a brachial plexus injury—can also damage the radial nerve.

The radial nerve may also be injured by compression. For example, wearing a tight watchband, using crutches improperly, or sleeping or sitting with awkward pressure on the upper arm can compress the nerve. Nearby structures, including abnormal structures like tumors, can sometimes cause compression.

Repetitive motions that involve grasping and swinging may damage the radial nerve over time. Examples include hammering and practicing sports such as tennis or golf.

Finally, systemic conditions can affect the nerves, including the radial nerve. These conditions include diabetes, liver dysfunction, kidney dysfunction, and vitamin deficiency.

Treatments

Many radial nerve injuries heal on their own. Others require surgical treatment. Surgery type will depend on the injury. At the Peripheral Nerve Center, we have expertise in all types of peripheral nerve surgery.

To repair a torn or lacerated nerve, a peripheral nerve surgeon may rejoin the cut ends of the nerve to one another. However, if injured nerve tissue must be removed, there may be a gap of such size that the nerve ends cannot be directly reconnected. In that case, a nerve graft can be performed to bridge the gap.

A compressed nerve may need to be surgically released from compression. This may be accomplished with a typical nerve decompression surgery or a tumor excision surgery for nerves compressed by a mass.