RADIAL NERVE

RAJADURAI R
CRRI, ORTHOPEDICS II UNIT
RGGGH
 INTRODUCTION
RADIAL NERVE / MUSCULOSPIRAL NERVE

Radial nerve is the largest branch of the posterior cord of the

brachial plexus.

 It carries fibres from all the roots (C5,C6,C7,C8,And T1) But T1

fibres are not constant.

 It is a mixed nerve.
BRACHIAL PLEXUS :
INNERVATION OF RADIAL NERVE :
ARM
MUSCULAR INNERVATION:
BEFORE THE SPIRAL GROOVE :
lnog head of triceps
medial head of triceps
AT THE SPIRAL GROOVE :
medial head of triceps
lateral head of triceps
anconeus
ATER THE SPIRAL GROOVE
brachialis
brachioradialis
extensor carpi radialis longus
 RADIAL NERVE PALSY

HIGH RADDIAL NERVE PALSY:

CAUSES:
fracture of shaft of humerus
prolonged application of tourniquet
Saturday night palsy
CLINICAL FEATURES:
Elbow extension is spared(due to sparing of long and medial head of triceps ).

loss of extension of
thumb
wrist
fingers
loss of sensation over the 1 web of the dorsum of the hand
LOW RADIAL NERVE PALSY
CAUSES:
Dislocation of elbow
fracture of neck of radius
enlarged bursae
CLINICAL FEATURES;
Elbow extension spared with weak wrist extension with radial deviation .
Loss of extension of thumb and finger

loss of sensation over the dorsum of first web space

 RADIAL NERVE INJURY - TESTS
Elbow extension against gravity and resistance.

Extension of wrist – Total inability to extend wrist in radial

nerve lesion and Extension with radial
deviation in PIN lesions (due to spared ECRL and ECRB and
paralysed ECU)

Extension of fingers at MCP joints - lost

Extension of thumb at IP joint - lost

Sensation – lost in dorsum of I web space

TESTING OF TRICEPS MUSCLE
TRICEPS TESTING
Extensor carpi radialis longus (ECRL) and brevis extend the wrist
and assist in wrist abduction. Examination involves having the
subject extend the wrist and imposing force in the opposite
direction
POSITION: The elbow is positioned in extension.
STABILIZE: The forearm is stabilized.
RESIST: The subject attempts wrist extension while giving
resistance to the examiner's opposing force
 RADIAL NERVE ENTRAPMENTS

• Holstein-Lewis fracture - # at the junction of the middle and

distal thirds.
• Lateral intermuscular septum
• Compression at the fibrous arch of the lateral head of the
triceps muscle
• Compression by an accessory subscapularis-teres-latissimus
muscle
• Posterior interosseous nerve syndrome
• Wartenberg syndrome
 RADIAL TUNNEL SYNDROME

Five sites of potential compression of the PIN:

 1. Proximal origin of the ECRB or fibrous
bands within the ECRB
 2. Thickened fascial tissue superficial to the
radiocapiteller joint
 3. Leash of Henry (Radial recurrent vessels)
 4. Arcade of Frohse (Proximal border of the
supinator muscle)
 5. Distal border of the supinator muscle
THANK YOU