Radial nerve palsy: An analysis of 50 cases

Objective: To identify causes of radial nerve palsy and look for the incidence of intramuscular injection as its cause in our population. Design: A prospectively conducted descriptive study. Place and Duration of Study: This study was conducted in the Department of Neurology, PIMS and "The Neurocentre", during January, 1999 to July, 2000. Subjects and Methods: Fifty patients of any age group and sex, through detailed history/clinical examination followed by electrophysiological confirmation of radial nerve palsy were included. The damage was localized by stimulating radial nerve at various sites along its course and findings of nerve conduction studies (NCS) as well as electromyogram (EMG) were recorded. Patients found to have C 7, 8 radiculopathy on electrophysiological testing, brachial plexus injury or those having central causes were excluded from the study. Results: Among 50 patients of radial nerve palsy 38 (76%) were males and 12 (24%) females. The causes found were as follows, 9 (18%) patients had radial nerve palsy secondary to intramuscular injection while in 7(14%) the cause was deep (unphysiological) sleep, in 12(24%) patients fracture of long bones in the upper limb, in 9 (18%) postoperative lesion, bullet injury in 7(14%) patients, dislocation of elbow in 2 (4%) patients and sharp cut injury resulted in radial nerve damage in 4 (8%) respectively. Conclusion: Trauma was the leading cause of radial nerve palsy followed by intramuscular injection-related radial neuropathy which is an avoidable cause requiring a mass education of paramedical workers to prevent this hazard.