What is the role of surgery in the treatment of radial mononeuropathy?

Updated: Jun 14, 2018
  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Surgical exploration may be considered for a chronic compressive lesion or transection.

  • Surgical exploration frequently is indicated for release of the nerve from tethered points in the forearm.

  • Localizing the lesion prior to surgery via EMG is important to assist the surgeon in identifying which section of the nerve is most likely involved.

  • When transection is suspected as the mechanism of injury, conservative management for several months is indicated to assure that no nerve regrowth has occurred either clinically or by electrodiagnostic measures.

  • If no regeneration or inadequate regeneration is confirmed, surgical exploration with possible re-anastomosis may be indicated.

  • Selective tendon transfer may allow for finger extension and thumb extension in cases of long-standing, irreparable radial nerve lesions. [14, 15]

  • Consensus has not been reached regarding the need for and timing of surgical therapy to treat radial nerve palsy with accompanying humeral fracture. [16, 17, 18, 19]


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