Definition and Diagnosis

The radial nerve is located very close to the humerus (upper arm bone) and therefore can be injured with fractures of this bone. In fact, the radial nerve is probably the most common major nerve to be injured by trauma; it occurs in about 15% of humeral fractures. Among other functions, the radial nerve controls sensation on the back of the hand, along with wrist and finger extension. Therefore patients with radial nerve injuries at the humerus have a wrist and finger drop. The nerve may be injured by the traumatic force itself, getting caught in the fracture once it's reduced, under a surgical plate (rare), or it even may be trapped by healing bone. The diagnosis of radial nerve injury is confirmed with history, physical examination, and electrical testing.

Treatment Options

The sharp edge of a humeral fracture injured this radial nerve causing marked wrist and finger weakness.

Fortunately, most radial nerve palsies recovery spontaneously within 3 months and nerve surgery is not required. Nevertheless, some patients require surgery either immediately, or a few months later. Surgery is performed to release compression of the nerve, or to repair it with sutures or grafting if there is no function seen during intraoperative testing (see technology and techniques available section). Physical therapy and custom made wrist/finger splints are prescribed during recovery.