Wartenberg's Syndrome: Difference between revisions
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The SRN is the superficial sensory branch of the radial nerve. After the radial nerve bifurcates into the SRN and PIN, the SRN courses distally into the forearm deep to the brachioradialis. Approximately 9 cm proximal to the radial styloid, the SRN becomes a subcutaneous structure by traveling between the brachioradialis and ECRL tendons . <ref name="abrams">Abrams RA, Brown RA, Botte MJ. The superficial branch of the radial nerve: an anatomic study with surgical implications. J Hand Surg 1992;17A:1037–1041</ref> The SRN continues to travel in the subcutaneous tissues and branches out into dorsal digital nerves responsible for afferent sensory input from the dorsum of the thumb, index, and middle fingers proximal to the proximal interphalangeal joints.<ref name="alan">Alan C. Dang, MD, Craig M. Rodner, MD, Unusual Compression Neuropathies of the Forearm,Part I: Radial Nerve; J Hand Surg 2009;34A:1906–1914. © 2009 Published by Elsevier Inc.on behalf of the American Society for Surgery of the Hand</ref><br> | The SRN is the superficial sensory branch of the radial nerve. After the radial nerve bifurcates into the SRN and PIN, the SRN courses distally into the forearm deep to the brachioradialis. Approximately 9 cm proximal to the radial styloid, the SRN becomes a subcutaneous structure by traveling between the brachioradialis and ECRL tendons . <ref name="abrams">Abrams RA, Brown RA, Botte MJ. The superficial branch of the radial nerve: an anatomic study with surgical implications. J Hand Surg 1992;17A:1037–1041</ref> The SRN continues to travel in the subcutaneous tissues and branches out into dorsal digital nerves responsible for afferent sensory input from the dorsum of the thumb, index, and middle fingers proximal to the proximal interphalangeal joints.<ref name="alan">Alan C. Dang, MD, Craig M. Rodner, MD, Unusual Compression Neuropathies of the Forearm,Part I: Radial Nerve; J Hand Surg 2009;34A:1906–1914. © 2009 Published by Elsevier Inc.on behalf of the American Society for Surgery of the Hand</ref><br> | ||
== Pathophysiology == | |||
The SRN can be compressed at any point along its course in the forearm, but it is believed to be at greatest risk at the posterior border of the brachioradialis as the nerve transitions from a deep to a subcutaneous structure. Trauma is also a common etiology for SRN compression, which can occur from direct pressure on the nerve (ie, by a wristband or handcuffs ) or from a stretch injury to the nerve (ie, during a closed reduction of a forearm fracture ) <ref name="alan" /> | |||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
<div class="researchbox"><rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1JcY43SP_RPRSMJttnbJOHbjkml9j3c3r6OuQvBywsz1o1Cwdt|charset=UTF-8|short|max=10</rss></div> | <div class="researchbox"><rss>http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1JcY43SP_RPRSMJttnbJOHbjkml9j3c3r6OuQvBywsz1o1Cwdt|charset=UTF-8|short|max=10</rss></div> | ||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 17:20, 28 December 2014
Introduction
[edit | edit source]
Wartenberg's Syndrome is described as the entrapment of the superficial branch of the radial nerve[1] with only sensory manifestations and no motor deficits. In this condition,the patient complains of pain over the distal radial forearm associated with paresthesias over the dorsal radial hand.[2] This should not be confused with Wartenberg's Sign which refers to the slightly greater abduction of the fifth digit, due to paralysis of the abducting palmar interosseous muscle and unopposed action of the radial innervated extensor muscles (digiti minimi, digitorum communis ).[3]
Background [4][edit | edit source]
In 1932, Wartenberg described five cases of isolated neuropathy of the Superficial Radial Nerve . He was so impressed by the similiarity to the isolated involvement of the lateral cutaneous nerve of the thigh, Meralgia Paraesthetica, that he suggested the name Cheiralgia Paraesthetica. The condition is sometimes referred to as Wartenberg's Disease.But Wartenberg was not the first to draw attention to it. He cited the early accounts of other authors in his description.
Anatomy[edit | edit source]
The SRN is the superficial sensory branch of the radial nerve. After the radial nerve bifurcates into the SRN and PIN, the SRN courses distally into the forearm deep to the brachioradialis. Approximately 9 cm proximal to the radial styloid, the SRN becomes a subcutaneous structure by traveling between the brachioradialis and ECRL tendons . [5] The SRN continues to travel in the subcutaneous tissues and branches out into dorsal digital nerves responsible for afferent sensory input from the dorsum of the thumb, index, and middle fingers proximal to the proximal interphalangeal joints.[6]
Pathophysiology[edit | edit source]
The SRN can be compressed at any point along its course in the forearm, but it is believed to be at greatest risk at the posterior border of the brachioradialis as the nerve transitions from a deep to a subcutaneous structure. Trauma is also a common etiology for SRN compression, which can occur from direct pressure on the nerve (ie, by a wristband or handcuffs ) or from a stretch injury to the nerve (ie, during a closed reduction of a forearm fracture ) [6]
Recent Related Research (from Pubmed)[edit | edit source]
References[edit | edit source]
- ↑ Tosun N, Tuncay I, Akpinar F. Entrapment of the sensory branch of the radial nerve (Wartenberg's syndrome): an unusual cause ;Tohoku J Exp Med. 2001 Mar;193(3):251-4.
- ↑ Sudarshan SURENDRAN,Seetharama Manjunatha BHAT ,Ashwin KRISHNAMURTHY;Compression of radial nerve between the split tendon of brachioradialis muscle: a case report:Neuroanatomy; 2006; 5: 4–5.
- ↑ A.J. Larner; A Dictionary of Neurological Signs; Springer Science &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; Business Media, 12-Nov-2010; page 369
- ↑ A.S.Braidwood, Glassgow, Scotland :Superficial Radial Neuropathy ;JBJS;VOL. 57-B, No. 3, AUGUST 1975
- ↑ Abrams RA, Brown RA, Botte MJ. The superficial branch of the radial nerve: an anatomic study with surgical implications. J Hand Surg 1992;17A:1037–1041
- ↑ 6.0 6.1 Alan C. Dang, MD, Craig M. Rodner, MD, Unusual Compression Neuropathies of the Forearm,Part I: Radial Nerve; J Hand Surg 2009;34A:1906–1914. © 2009 Published by Elsevier Inc.on behalf of the American Society for Surgery of the Hand
