橈骨神経麻痺

WordNet

relating to or near the radius; "the radial aspect of the forearm"
pneumatic tire that has radial-ply casing (同)radial tire, radial-ply_tire
arranged like rays or radii; radiating from a common center; "radial symmetry"; "a starlike or stellate arrangement of petals"; "many cities show a radial pattern of main highways" (同)stellate, radiate
issuing in rays from a common center; relating to rays of light; "radial heat"
relating to or moving along or having the direction of a radius; "radial velocity"
any bundle of nerve fibers running to various organs and tissues of the body (同)nervus
a condition marked by uncontrollable tremor
affect with palsy
become friends; act friendly towards (同)pal up, chum up
control of your emotions; "this kind of tension is not good for my nerves"

PrepTutorEJDIC

光線の / 放射状の / 半径の
=radial-ply tire
〈C〉『神経』 / 〈C〉《複数形で》『神経過敏』,いらだち / 〈U〉『勇気』,度胸(courage) / 〈U〉《時にa ~》厚かましさ,ずぶとさ;無礼 / 〈C〉葉脈;(昆虫の)翅脈(しみゃく) / 〈人,特に自分〉‘に'力を与える,‘を'元気づける
麻痺(まひ),中風 / …‘を'麻痺させる(paralyze)
《話》『友達』,仲間,親友 / (…と)仲よくなる《[『up』]『with』+『名』》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/06/04 00:03:42」(JST)

wiki en

Wrist drop, also known as radial nerve palsy, is a condition where a person cannot extend their wrist and it hangs flaccidly. To demonstrate wrist drop, hold your arm out in front of you with your forearm parallel to the floor. With the back of your hand facing the ceiling (i.e. pronated), let your hand hang limply so that your fingers point downward. A person with wrist drop would be unable to move from this position to one in which the fingers are pointing up towards the ceiling.

Anatomy of the forearm

In anatomical parlance, the forearm is the part of the body which extends from the elbow to the wrist and is not to be confused with the arm which extends from the shoulder to the elbow. The extensor muscles in the forearm are extensor carpi ulnaris, extensor digiti minimi, extensor digitorum, extensor indicis, extensor carpi radialis brevis, extensor carpi radialis longus. These extensor muscles are supplied by the posterior interosseous nerve, a branch of the radial nerve. Other muscles in the forearm also innervated by the radial nerve are supinator, extensor pollicis brevis, extensor pollicis longus, and abductor pollicis longus. Note that all these muscles are situated in the posterior half of the forearm (posterior when in the anatomical position). Also, brachioradialis, anconeus, triceps brachii, and extensor carpi radialis longus are all innervated by muscular branches of the radial nerve in the arm.

Causes

Wrist extension is achieved by muscles in the forearm contracting, pulling on tendons that attach distal to (beyond) the wrist. If the tendons, the muscles, or the nerves supplying these muscles, are not working as they should be, wrist drop may occur. The following situations may result in wrist drop:

Stab wounds to the chest at or below the clavicle may result in wrist drop. The radial nerve is the terminal branch of the posterior cord of the brachial plexus. A stab wound may damage the posterior cord and result in neurological deficits including an inability to abduct the shoulder beyond first 15 degrees, an inability to extend the forearm, reduced ability to supinate the hand, reduced ability to abduct the thumb and sensory loss to the posterior surface of the arm and hand.

The radial nerve can be damaged if the humerus (the bone of the arm) is broken, because it runs through the radial groove on the lateral border of this bone along with the deep brachial artery.

Wrist drop is also associated with lead poisoning because of the effect of lead on the radial nerve.^[1]

Persistent injury to the nerve is also a common cause through either repetitive motion or by applying pressure externally along the route of the radial nerve as in the prolonged use of crutches or extended leaning on the elbows.÷

1) Weakness of brachioradialis, wrist extension and finger flexion = radial nerve lesion (2) weakness of finger extension and radial deviation of the wrist on extension = posterior interossious nerve lesion (3) weakness of triceps, finger extensors and flexors = c7,8 lesion (4) generalised weakness of upper limb marked in deltoid, triceps, wrist extension and finger extension = corticospinal lesion

Diagnosis

The workup for wrist drop frequently includes nerve conduction velocity studies to isolate and confirm the radial nerve as the source of the problem. Plain films can help identify bone spurs and fractures that may have injured the nerve. Sometimes MRI imaging is required to differentiate subtle causes.

Treatment

Initial management includes splinting of the wrist for support along with Chiropractic, Physiotherapy and occupational therapy. In some cases, surgical removal of bone spurs or other anatomical defects that may be impinging on the nerve might be warranted.

References

^ Dedeken P, Louw V, Vandooren AK, Geert V, Goossens W, Dubois B (2006). "Plumbism or lead intoxication mimicking an abdominal tumor". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine 21 (6): C1–3. doi:10.1111/j.1525-1497.2006.00328.x. PMC 1924641. PMID 16808730.

External links

clinicalconsiderations at The Anatomy Lesson by Wesley Norman (Georgetown University)
617611280 at GPnotebook

UpToDate Contents

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English Journal

Response to "Direct Radial to Ulnar Nerve Transfer to Restore Intrinsic Muscle Function in Combined Proximal Median and Ulnar Nerve Injury: Case Report and Surgical Technique".

Power D1, Nassimizadeh M1, Samson D1.
The Journal of hand surgery.J Hand Surg Am.2015 Apr;40(4):858. doi: 10.1016/j.jhsa.2014.10.067.
PMID 25813926

Rerouting Extensor Pollicis Longus Tendon Transfer.

Colantoni Woodside J1, Bindra RR2.
The Journal of hand surgery.J Hand Surg Am.2015 Apr;40(4):822-825. doi: 10.1016/j.jhsa.2015.01.018. Epub 2015 Mar 5.
Following radial nerve palsy, loss of the extensor pollicis longus (EPL), abductor pollicis longus and extensor pollicis brevis tendons results in loss of thumb extension and radial abduction. Multiple tendon transfers are described to address the loss of thumb extension following radial palsy utili
PMID 25746145

Plate osteosynthesis of humeral diaphyseal fractures associated with radial palsy: twenty cases.

Pailhé R1, Mesquida V, Rubens-Duval B, Saragaglia D.
International orthopaedics.Int Orthop.2015 Mar 28. [Epub ahead of print]
BACKGROUND: Surgical management of humeral fractures associated with radial nerve palsy remains controversial. Some advocate surgical treatment in emergency while others recommend nonoperative treatment.PURPOSE: The aim of the study was to assess nerve recovery in a series of patients treated with o
PMID 25813460

Japanese Journal

橈骨神経麻痺に対する簡易式ダイナミックスプリントの考案 (第24回日本臨床整形外科学会学術集会)

柳川哲二
日本臨床整形外科学会雑誌 38(1), 17-21, 2013-07
NAID 40019767241

臨床室外傷性橈骨神経麻痺に合併した肘関節後外側回旋不安定性の1例

村山敦彦,矢﨑尚哉,大山慎太郎 [他]
整形外科 = Orthopedic surgery 64(7), 625-627, 2013-07
NAID 40019747921

撓骨神経麻痺が前景に立った神経痛性筋萎縮症の1例

坪井博文,菅野直人,西山亜由美 [他]
臨床神経学 53(4), 312-315, 2013-04
NAID 40019663412

Related Pictures

★リンクテーブル★

リンク元	「橈骨神経麻痺」
関連記事	「radial」「palsy」「nerve」

「橈骨神経麻痺」

Wrist drop
	Classification and external resources
	The suprascapular, axillary, and radial nerves.
ICD-10	M21.3
ICD-9	736.05

　　[★]

英: radial nerve palsy
同: saturday night paralysis
関: 橈骨神経、下垂手

橈骨神経	正中神経	尺骨神経
下垂手	猿手	鷲手
下垂手	祝福の手	鷲手

尺骨神経麻痺		正中神経麻痺		橈骨神経麻痺
小指球筋萎縮		母指、示指の屈曲障害	(祈祷手)	手関節背屈障害	(下垂手)
骨間筋萎縮		母指球の萎縮	(猿手)	指MP関節進展	(下垂指)
中節・末節屈曲位	(鷲手)	母指の対立障害
指内転・外転不能	(フロマン徴候陽性)