From the Research
Radial nerve injury management should prioritize a comprehensive approach, focusing on early protection, physical therapy, and timely surgical intervention when necessary, as evidenced by the most recent study 1. The management of radial nerve injury requires a multifaceted strategy, taking into account the severity and location of the damage. Initial treatment should focus on protecting the affected limb with a wrist splint or brace to prevent further injury and maintain proper positioning.
- Physical therapy is essential and should begin early, including passive range of motion exercises to prevent joint stiffness and muscle atrophy.
- As recovery progresses, strengthening exercises targeting the wrist and finger extensors should be incorporated. For mild injuries (neuropraxia), conservative management is typically sufficient, with most patients recovering within 3-6 months.
- However, for more severe injuries with axonal damage, surgical intervention may be necessary if no improvement occurs after 3-4 months of conservative treatment, as supported by 2 and 1. Surgical options include nerve repair, grafting, or tendon transfers depending on the extent of damage.
- Pain management may include medications such as gabapentin (300-1200 mg three times daily) or pregabalin (75-300 mg twice daily) for neuropathic pain, as discussed in 3. Electrical stimulation therapy can also help maintain muscle tone during recovery.
- Regular follow-up with nerve conduction studies every 6-8 weeks helps monitor progress, and the prognosis depends on the injury mechanism, with compression injuries having better outcomes than complete transections, as noted in 4 and 5. Recovery occurs at approximately 1 mm per day or 1 inch per month as axons regenerate from the injury site to target muscles. The most recent study 1 highlights the efficiency of neurolysis and sural nerve graft interposition as secondary treatment interventions, especially for radial nerve lesions, with regeneration to a satisfactory degree observed in all patients, and the majority achieving full recovery of sensory and motor functions.