Radial Nerve: Anatomy, Injury, and Treatment
Abstract
The radial nerve is a major peripheral nerve of the upper limb, providing sensory and motor innervation to the muscles of the posterior compartment of the arm and the skin of the posterior forearm and dorsum of the hand. Injury to the radial nerve can cause serious disability and can be caused by a fall onto the outstretched hand, direct trauma, or compression. This article provides an overview of the anatomy and innervation of the radial nerve, the causes and symptoms of radial nerve injury, and the treatment approaches used to address these injuries.
Introduction
The radial nerve is a major nerve of the upper limb, providing sensory and motor innervation to the muscles of the posterior compartment of the arm and the skin of the posterior forearm and dorsum of the hand. Injury to the radial nerve can cause significant disability and can be caused by a fall onto the outstretched hand, direct trauma, or compression.
Anatomy
The radial nerve is the largest nerve in the posterior compartment of the arm and is a branch of the brachial plexus. It originates in the axilla and descends through the spiral groove of the humerus, extending to the posterior forearm. The nerve then branches into the superficial radial nerve and the deep radial nerve. The superficial radial nerve supplies sensation to the skin of the dorsum of the hand, while the deep radial nerve innervates the extensor muscles of the forearm and wrist.
Injury
Radial nerve injury can be caused by a direct trauma or a fall onto the outstretched hand, as well as by compression or entrapment of the nerve. Common causes of compression or entrapment of the radial nerve include the use of a cast, fractures of the humerus, and the positioning of the arm during surgery. Symptoms of radial nerve injury include numbness and tingling of the skin of the posterior forearm and hand, pain in the posterior arm and forearm, and weakness of the muscles of the posterior compartment of the arm.
Treatment
Treatment of radial nerve injury depends on the severity and cause of the injury. If the nerve was compressed or entrapped, the first step is to address the underlying cause. For example, if the nerve was compressed by a cast, the cast should be removed. In cases of direct trauma or fractures of the humerus, surgical repair may be necessary. In addition, physical therapy can be used to improve muscle strength and coordination.
Conclusion
Radial nerve injury can cause significant disability and can be caused by direct trauma, a fall onto the outstretched hand, compression or entrapment of the nerve, or fractures of the humerus. Treatment depends on the severity and cause of the injury and may involve surgical repair and physical therapy.
References
Al-Qattan, M. M., & Al-Mousawi, A. M. (2017). Radial nerve. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK539788/
Buford, W. L., & Jain, S. (2018). Radial nerve injury. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532185/
Kumar, V., & Abbas, A.K. (2017). Radial nerve injuries. In Robbins and Cotran Pathologic Basis of Disease (10th ed., pp. 1318-1319). Philadelphia: Elsevier.