Compressive neuropathy in the upper limb

Abstract

Entrampment neuropathy or compression neuropathy is a fairly common problem in the upper limb. Carpal tunnel syndrome is the commonest, followed by Cubital tunnel compression or Ulnar Neuropathy at Elbow. There are rarer entities like supinator syndrome and pronator syndrome affecting the Radial and Median nerves respectively. This article seeks to review comprehensively the pathophysiology, Anatomy and treatment of these conditions in a way that is intended for the practicing Hand Surgeon as well as postgraduates in training. It is generally a rewarding exercise to treat these conditions because they generally do well after corrective surgery. Diagnostic guidelines, treatment protocols and surgical technique has been discussed.

Traumatic Neuropathy of the Trigeminal Nerve in a College Trumpet Player: A Case Report

“…Because the patient had a compression mononeuropathy and not an entrapment neuropathy, we did not prescribe steroids or nonsteroidal anti‐inflammatory drugs (NSAIDs) as part of our treatment. The literature supports the use of steroids or NSAIDs for entrapment neuropathies, but our patient had a compression neuropathy [6]. One could speculate steroids or NSAIDs may have sped the healing process of our patient, but temporarily removing the external force causing the compression was easy and had fewer side effects than medications.…”

Posterior interosseous nerve syndrome secondary to compression by an intramuscular hemangioma

“…In summary, posterior interosseous nerve syndrome secondary to intramuscular hemangioma is rare. Prolonged nerve compression can result in axonal degeneration and irreversible neuropathological changes, thereby affecting prognosis . For patients who are suspected of having a posterior interosseous nerve syndrome but who lack a characteristic medical history or clinical manifestations, imaging examinations may be required to confirm the diagnosis and to identify the cause and location of nerve compression.…”

Effects of chronic flexed wrist posture on the elasticity and crosssectional area of the median nerve at the carpal tunnel among chronic stroke patients

“…It means that the CSA of the median nerve decreases as time passes by due to chronic compression. Histologically compression neuropathy causes edema, fibrosis, demyelination, and Wallerian degeneration [7]. The negative correlation among the CSA of the nerve and the duration of time since stroke means that the CSA of the median nerve decreases as the time of exposure to compression increases.…”