Special issue: nerve compression syndromes "Brachioradialis, or "High Wartenberg", syndrome - compression of the sensory branch of the radial nerve in the proximal forearm.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-04-01 Epub Date: 2024-10-17 DOI:10.1007/s00264-024-06350-x

Elisabet Hagert, Camila Azocar, Ulrika Jedeskog, Ashraf Hantouly

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引用次数: 0

Abstract

Purpose: Compression of the sensory branch of the radial nerve (SBRN) in the proximal forearm is an uncommon condition, leading to both motor and sensory deficits. The aim of this study is to assess the surgical outcomes of SBRN release at the level of the brachioradialis arcade.

Methods: A retrospective study of prospectively collected data was conducted on patients undergoing brachioradialis release (BRR) from March 2014 to March 2021. The measured outcomes included quick-DASH (Disability of the Arm Shoulder Hand questionnaire), work-DASH, visual analog scale (VAS) scores for pain, and patient satisfaction with surgery, at a minimum six month follow-up.

Results: A total of twenty patients (mean age of 44.1 (range 25-62) were included in this study, of which nine (45%) were males. Eleven patients (55%) underwent isolated BRR, while the other nine patients (45%) underwent concomitant BRR and lacertus release. The three most common presenting symptoms in patients with isolated BRS were radiovolar forearm pain (100%), disturbed sensation in the SBRN territory (85%), and hand/thumb fatigue (75%). Forearm pain and fatigue were found in all patients with combined BRS and lacertus syndrome. The response rate for the functional outcome scores was 65% (13/20). Quick-DASH significantly improved (preoperative 29.6 (range 13.6-57.5) to postoperative 6.9 (range 0-27.27), p < 0.0001) as did the work DASH (p < 0.0001). Follow-up VAS Pain was 1 and satisfaction with surgery 9.6.

Conclusion: BRS is an uncommon radial nerve compression syndrome in the proximal forearm that differs from the more commonly recognized radial tunnel syndrome. It presents with radio-volar forearm pain, disturbed sensation in the SBRN distribution, and loss of hand/thumb endurance. Minimally invasive BRR immediately restores wrist extension strength, significantly improves DASH scores, and yields positive outcomes at a minimum six-month follow-up.

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特刊：神经压迫综合征 "肱神经或 "高瓦腾伯格 "综合征--前臂近端桡神经感觉支受压。

目的：前臂近端桡神经感觉支（SBRN）受压是一种不常见的情况，会导致运动和感觉障碍。本研究旨在评估肱骨弧水平的桡神经感觉支松解手术效果：对2014年3月至2021年3月期间接受肱骨弧松解术（BRR）的患者进行了一项前瞻性数据收集的回顾性研究。测量结果包括至少 6 个月随访的快速-DASH（手臂肩部手部残疾问卷）、工作-DASH、疼痛视觉模拟量表（VAS）评分以及患者对手术的满意度：本研究共纳入 20 名患者（平均年龄 44.1 岁（25-62 岁不等），其中 9 名（45%）为男性。11 名患者（55%）接受了单独的 BRR，另外 9 名患者（45%）同时接受了 BRR 和裂隙松解术。孤立 BRRS 患者最常见的三个症状是前臂放射性疼痛（100%）、SBRN 区域感觉障碍（85%）和手/拇指疲劳（75%）。所有合并 BRS 和拉克综合征的患者都会出现前臂疼痛和疲劳。功能结果评分的应答率为 65%（13/20）。Quick-DASH 有明显改善（术前 29.6（范围 13.6-57.5），术后 6.9（范围 0-27.27），P 结论：桡神经受压综合征是一种不常见的前臂近端桡神经受压综合征，它不同于更常见的桡骨隧道综合征。它表现为前臂放射性疼痛、SBRN 分布的感觉障碍以及手/拇指耐力丧失。微创 BRR 可立即恢复腕部伸展力量，显著改善 DASH 评分，并在至少 6 个月的随访中取得积极疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.