Peripheral nerve syndromes

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Background

Clinical Features

Cutaneous innervation of the upper limb
Lower limb peripheral innervation

Peripheral nerve syndromes

  • Upper extremity
    • Ulnar
      • Cause of Injury: Elbow injury.
      • Sensory changes in the 5th and medial half of 4th digits, weak wrist flexors, “claw hand”
    • Radial
    • Median, distal
      • Cause of Injury: Wrist dislocation, laceration, Carpal Tunnel Syndrome
      • Weak flexion of radial half of digits and thumb, loss of abduction and opposition of thumb. Ape hand deformity, benediction sign. Loss of sensation of lateral three and one-half digits and nail beds
    • Median, proximal
    • Musculocutaneous
      • Cause of Injury: Anterior shoulder dislocation, entrapment due to hypertrophy
      • Elbow flexion and supination weakness, radial forearm sensory deficits
    • Axillary
  • Lower extremity
    • Femoral
      • Cause of Injury: Pubic rami fracture, pelvic fractures
      • Weak knee extension, anterior knee sensory deficits
    • Obturator
    • Posterior tibial
      • Cause of Injury: Knee dislocation
      • Weak toe flexion, plantar foot sensory deficit
    • Superficial peroneal
      • Cause of Injury: Fibular neck fracture, knee dislocation
      • Weak ankle eversion, lateral dorsal foot sensory deficits
    • Deep peroneal
      • Cause of Injury: Fibular neck fracture, compartment syndrome
      • Sensory deficit at dorsal 1st web space, weak ankle and toe dorsiflexion
    • Sciatic
      • Cause of Injury: Posterior hip dislocation
      • Lower leg weakness, foot drop, leg sensory deficits
    • Superior gluteal
    • Inferior gluteal
      • Cause of Injury: Acetabular pelvic fracture, s/p hip replacement
      • Abnormal gait, gluteus maximus weakness resulting in gluteus maximus lurch

Differential Diagnosis

Upper extremity peripheral nerve syndromes

Median Nerve Syndromes

Ulnar Nerve Syndromes

Radial Nerve Syndromes

Proximal Neuropathies

Other

Extremity trauma

Evaluation

Management

Disposition

See Also