Cause analysis and outcome assessment of surgical treatment in patients of severe radial nerve injury caused by compression in the upper arm

Objective To assess the surgical outcomes of severe radial nerve injury caused by compression in the upper arm.Methods Eight patients of severe radial nerve injury caused by compression in the upper arm who received surgery in our department from March 2005 to August 2009 were analyzed retrospectively.Wrist drop happened after being drunk in 5 patients and after traumatic coma in 3 patients.The interval from paralysis to surgery was 2 to 6 months(mean 3.6 months).All patients were treated surgically.The radial nerve was exposed to reveal compression constrictions at the main trunk of the radial nerve and the posterior interosseous nerve.Sausage-like changes were seen in 5 cases.There were two-part sausage-like changes in 3 cases.External neurolysis was carried out in 3 cases,while resection of the constricted portions of the nerves was done in the other 5 patients.Direct nerve coaptation was achieved in 2 cases whereas nerve-grafting had to be done in 3 cases.Results The patients were follow-up from 9 months to 3 years after the operation.Six patients regained at least grade-4 muscle power in the involved muscles.The other two patients who had been treated by nerve-grafting had poor results.According to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association the treatment outcomes were good in 4 cases,fair in 2 cases and poor in 2 cases.Conclusion Surgical treatment is effective for most of the severe compressive radial nerve injury patients. Key words: Radial nerve;  Microsurgery;  Compression