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Radial tunnel syndrome

This is one of the rarer nerve compression syndromes of one of the nerves that goes down to the forearm. It supplies an area of sensation on the back of the hand in between the index finger and thumb. The syndrome is generally confused with tennis elbow and often tennis elbow that is resistant to treatment may well be in fact a radial tunnel syndrome.

ANAESTHETIC

General or regional anaesthetic.

OPERATIVE PROCEDURE

A cut is made in the outer aspect of the upper arm curving into the elbow crease and then doing a zig zag down the forearm on the thumb side. This is quite a big incision. The skin flaps are raised and nerve is identified around the outer aspect of the biceps muscle and is traced further down the arm using careful dissection. Blood vessels need to be cut that go over the nerve and the nerve is then released throughout its course. The wound is closed in layers and the skin closed with nylon.

POST OPERATIVELY

A sticky dressing is placed over the wound and the elbow is elevated as much as possible. A bulky dressing is applied which needs to be maintained for 2 - 7 days and is then removed and the elbow mobilised. The patient is reviewed at two weeks for removal of sutures. Expect to be off work for 3-4 weeks.

COMPLICATIONS

  1. Infection - rare.
  2. Tendon damage - incredibly rare.
  3. Nerve damage - incredibly rare.
  4. Complex regional pain syndrome