- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States.
- Department of Plastic Surgery, Mayo Clinic, Phoenix, Arizona, United States.
Shelley S. Noland, M.D., Assistant Professor, Department of Surgery, Division of Plastic Surgery; Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, United States.
DOI:10.25259/SNI_673_2021Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Rohin Singh1, Yeonsoo Sara Lee1, Pelagia E. Kouloumberis1, Shelley S. Noland2. Right radial nerve decompression for refractory radial tunnel syndrome. 11-Oct-2021;12:507
How to cite this URL: Rohin Singh1, Yeonsoo Sara Lee1, Pelagia E. Kouloumberis1, Shelley S. Noland2. Right radial nerve decompression for refractory radial tunnel syndrome. 11-Oct-2021;12:507. Available from: https://surgicalneurologyint.com/?post_type=surgicalint_articles&p=11176
Background: Radial tunnel syndrome arises due to compression of the radial nerve through the radial tunnel.[
Case Description: A 68-year-old right-handed woman presented to the Mayo Clinic (Scottsdale, AZ) with the right elbow pain which radiated to the forearm causing significant difficulties with daily tasks. She had been dealing with worsening symptoms for 4 months. The patient’s history of gardening and clinical presentation allowed for diagnosis of radial tunnel syndrome. After conservative measures failed and other differential diagnoses were excluded, surgical decompression was recommended to treat her symptoms. The patient’s right arm was marked preoperatively between the brachioradialis and extensor carpi radialis longus (ECRL) muscles. The posterior cutaneous nerve of the forearm was identified which allowed for the determination of the interval between the brachioradialis and ECRL. Separation of the two muscles allowed for the identification of the radial sensory nerve. A nerve stimulator was used to confirm the sensory nature of this nerve. The nerve to the extensor carpi radialis brevis (ECRB) was identified and retracted with a vessel loop. Dorsal to the nerve to the ECRB is the posterior interosseous nerve (PIN), which was identified and retracted with a vessel loop. The fascia of the ECRB was divided both longitudinally and transversely and the supinator below was identified. The supinator muscle was carefully divided to further decompress the PIN. Informed consent for publication of this material was obtained from the patient.
Conclusion: The patient tolerated the procedure well and reported significantly reduced pain at 7-month follow-up. To the best of our knowledge, video tutorials on this procedure have not been published. This video can serve as an educational guide for peripheral nerve specialists dealing with similar lesions.
Keywords: Radial nerve, Peripheral nerve, Decompression, Radial tunnel syndrome
0:38 – Risks and benefits of procedure. 1:01 – Patient positioning. 5:15 – Procedure start. 6:15 – Disease background.
0:38 – Risks and benefits of procedure.
1:01 – Patient positioning.
5:15 – Procedure start.
6:15 – Disease background.
The authors certify that they have obtained all appropriate patient consent.
There are no conflicts of interest.
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