Radial Nerve Palsy ICD-10
Radial Nerve Palsy ICD-9
- 354.2 (Lesion of radial nerve; acute radial nerve palsy)
Radial Nerve Palsy Etiology / Epidemiology / Natural History
- Majority of injuries associated with fractures are neuropraxias which will spontaneously recover.
- Associated with humeral shaft fractures: most recover in 3-4 months, 11.1% of closed fx have associated Radial nerve palsy, 0.2% in closed fx's fail to recover. 18% open fx. 60% have nerve entrapped in fx. (Bostman O, Acta Orthop Scand 1986;57:316) . (Shaz JJ, Bhatti NA: CORR 1983;172:171. (Holstein A JBJS 1963;458:1382).
- More commonly associated with distal third humeral shaft fractures and transverse or spinal patterns than middle or proximal third fractures or oblique or comminuted fractures. (Shao YC, JBJS 2005;87Br:1647).
Radial Nerve Palsy Anatomy
- Brachioradialis should be first muscle to return.
Radial Nerve Palsy Clinical Evaluation
Radial Nerve Palsy Xray / Diagnositc Tests
- EMG indicated at 6 wks if no signs of recovery.
Radial Nerve Palsy Classification / Treatment
- Initial: patients should be placed in cock-up wrist splint, given thumb abduction and finger/wrist extension exercises to avoid contracture.
- If there is no sign of recovery clinically or on EMG at 4-6 months consider operative exploration. (Ekholm R, JBJS 2006;88Br:1469).
- CPT: 64722 (Decompression unspecified nerve)
Radial Nerve Palsy Associated Injuries / Differential Diagnosis
- Humeral shaft fracture
- Radial shaft fracture
Radial Nerve Palsy Complications
- Wrist / finger flexion contracture, loss of function
Radial Nerve Palsy Follow-up Care
- Mean time to onset of recovery is 7.3 weeks. Mean time to full recovery = 6.1 months. (Hak DJ, Orthopedics 2009;32:111)
Radial Nerve Palsy Review References
- Hak DJ, Orthopedics 2009;32:111
- Shao YC, JBJS 2005;87Br:1647