NERVE INJURY IN THE UPPER EXTREMITY- Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video describes nerve injury.
Long thoracic nerve injury: C5, C6, C7
•Medial winging of the scapula
Axillary nerve injury
•Dislocation of the humeral head
•Numbness over the deltoid region of the shoulder.
•Weakness of shoulder abduction due to deltoid weakness.
Anterior interosseous nerve injury
•Fracture dislocations around the elbow.
•The patient cannot do the O.K sign
•Typical pinch attitude with nerve injury
Posterior interosseous nerve injury
•The patient can perform wrist extension but no finger extension
Normal radial nerve function
•Extension of the wrist and the fingers
•A radial neve injury may occur by fractures involving the distal third of the humeral shaft.
Median nerve injury- Carpal tunnel syndrome
•Phalen ’s maneuver is a diagnostic test done to determine if the patient has carpal tunnel syndrome. This test is done by pushing the back of the hands together for one minute. This compresses the carpal tunnel and is also positive when it causes the same symptoms as carpal tunnel syndrome.
•Tinel’s test is positive when tapping on the nerve worsens the tingling of the fingers.
•Thenar atrophy is commonly associated with carpal tunnel syndrome.
•Carpal tunnel release is performed by cutting through the transverse carpal ligament to release the compressed nerve.
Ulnar nerve injury- Cubital tunnel syndrome
•Cubital tunnel syndrome occurs due to compression of the ulnar nerve at the elbow.
•As a result of cubital tunnel syndrome, the patient is unable to cross or abduct the fingers.
•Froment’s test: when pinching a piece of paper between the thumb and index finger, the thumb IP joint will flex if the adductor pollicis muscle is weak.
•Numbness and tingling on half of the ring finger and the entire little finger are common symptoms of ulnar nerve entrapment.
•Cubital tunnel release is accomplished by dividing the ligament to decrease compression on the nerve or with transposition of the nerve.
Lower ulnar nerve injury- Claw hand
•The claw hand deformity is a symptom of lower ulnar nerve entrapment below the elbow and typically causes flexion and clawing of the 4th and 5th finger
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