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Wartenberg's Syndrome

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Topic updated on 02/25/13 1:22pm
Introduction
  • A compressive neuropathy of the sensory branch of the radial nerve.
    • sensory manifestation only (no motor deficits)
  • Anatomic point of compression
    • between brachioradialis and ECRL during forearm pronation
Presentation
  • Symptoms
    • pain (does not like to wear watch)
    • numbness
    • paresthesias over radiodorsal hand
    • no motor weakness
  • Physical exam
    • provacative test performed with forceful forearm pronation for one minute and Tinel's sign over the nerve
    • Finkelstein test increases symptoms in 96% of patients
Treatment
  • Nonoperative
    • rest, activity modification (avoid aggravating activities), NSAIDS, and wrist splints
  • Operative
    • surgical decompression is indicated if symptoms persist after six months
      • anterior approach to forearm (Henry) is most common approach 
References
  1. Review of Orthopaedics, 4th Edition, Mark D. Miller, W B Saunders Co, March 2004 
  2. Orthopaedic Knowledge Update 8: Home study syllabus, Edited by Alexander R. Vaccaro, MD 
  3. Miller Colorado Review Lecture Series , Mark D. Miller, Stryker, 2005 
  4. Handbook of Fractures, Joseph D. Zuckerman, Kenneth J. Koval 
  5. Surgical Exposures in Orthopaedics: The Anatomic Approach, Stanley Hoppenfeld, Piet DeBoer
  6. Netter's Concise Atlas of Orthopaedic Anatomy, Frank H. Netter, John A. Craig, Frank H. Netter, John A. Craig, ICOH
  7. Physical Examination of the Spine & Extremities. Stanley Hoppenfeld.Prentice Hall. Copyright 1976

 

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