Evaluation of Patients Referred for Isolated Distal Upper Limb Extensor Weakness: A Retrospective Electrophysiological Study

Şeyma Aykaç; Seray İbiş Göksal; Abdullah Arı; Esra Aşıkdoğan; İbrahim Aydoğdu

Makale detayları

Evaluation of Patients Referred for Isolated Distal Upper Limb Extensor Weakness: A Retrospective Electrophysiological Study

Yazarlar:

Şeyma Aykaç | Seray İbiş Göksal | Abdullah Arı | Esra Aşıkdoğan | İbrahim Aydoğdu

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Nöroloji ve Nöromüsküler Hastalıklar

Dergi:

Osmangazi Tıp Dergisi Vol.47 Issue 6, pp.931-938

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350923

pISSN:

1305-4953

Anahtar kelimeler:

Özet:

 This study investigated the clinical and electrophysiological features of patients with isolated distal upper extremity extensor weakness, focusing on etiologies and anatomical levels of peripheral nerve involvement. A retrospective review included 57 patients evaluated between 2007 and 2025 with wrist or finger drop. All underwent motor and sensory conduction studies of the median, ulnar, and radial nerves, as well as needle EMG of radial nerveinnervated muscles and C7C8 roots. Radial nerve lesions were classified into three levels: Level 1 proximal to the triceps branch, Level 2 distal to triceps and proximal to supinator branches, and Level 3 posterior interosseous nerve. Nerve injuries were categorized as axonal or demyelinating. Of the 57 patients 40 men, 17 women, 56 had confirmed radial nerve injury. Trauma was the leading cause, followed by surgical and compression-related injuries. Electrophysiologically, Level 2 was the most frequent site, typically corresponding to distal humeral injuries. Level 1 injuries were associated with proximal humeral lesions, while Level 3 was linked to radial shaft involvement. All patients showed axonal damage: 49 partial, 28 total, and 23 prominent partial. Our results show that trauma-related radial nerve injury is the predominant cause of isolated distal extensor weakness. Electrophysiological evaluation is essential for accurate localization, diagnosis, and management.

 This study investigated the clinical and electrophysiological features of patients with isolated distal upper extremity extensor weakness, focusing on etiologies and anatomical levels of peripheral nerve involvement. A retrospective review included 57 patients evaluated between 2007 and 2025 with wrist or finger drop. All underwent motor and sensory conduction studies of the median, ulnar, and radial nerves, as well as needle EMG of radial nerveinnervated muscles and C7C8 roots. Radial nerve lesions were classified into three levels: Level 1 proximal to the triceps branch, Level 2 distal to triceps and proximal to supinator branches, and Level 3 posterior interosseous nerve. Nerve injuries were categorized as axonal or demyelinating. Of the 57 patients 40 men, 17 women, 56 had confirmed radial nerve injury. Trauma was the leading cause, followed by surgical and compression-related injuries. Electrophysiologically, Level 2 was the most frequent site, typically corresponding to distal humeral injuries. Level 1 injuries were associated with proximal humeral lesions, while Level 3 was linked to radial shaft involvement. All patients showed axonal damage: 49 partial, 28 total, and 23 prominent partial. Our results show that trauma-related radial nerve injury is the predominant cause of isolated distal extensor weakness. Electrophysiological evaluation is essential for accurate localization, diagnosis, and management.

 This study investigated the clinical and electrophysiological features of patients with isolated distal upper extremity extensor weakness, focusing on etiologies and anatomical levels of peripheral nerve involvement. A retrospective review included 57 patients evaluated between 2007 and 2025 with wrist or finger drop. All underwent motor and sensory conduction studies of the median, ulnar, and radial nerves, as well as needle EMG of radial nerveinnervated muscles and C7C8 roots. Radial nerve lesions were classified into three levels: Level 1 proximal to the triceps branch, Level 2 distal to triceps and proximal to supinator branches, and Level 3 posterior interosseous nerve. Nerve injuries were categorized as axonal or demyelinating. Of the 57 patients 40 men, 17 women, 56 had confirmed radial nerve injury. Trauma was the leading cause, followed by surgical and compression-related injuries. Electrophysiologically, Level 2 was the most frequent site, typically corresponding to distal humeral injuries. Level 1 injuries were associated with proximal humeral lesions, while Level 3 was linked to radial shaft involvement. All patients showed axonal damage: 49 partial, 28 total, and 23 prominent partial. Our results show that trauma-related radial nerve injury is the predominant cause of isolated distal extensor weakness. Electrophysiological evaluation is essential for accurate localization, diagnosis, and management.

 Bu çalışma, izole distal üst ekstremite ekstansör güçsüzlüğü bulunan hastaların klinik ve elektrofizyolojik özelliklerini inceleyerek etiyolojileri ve periferik sinir tutulumunun anatomik seviyelerini açıklamayı amaçlamaktadır. 20072025 yılları arasında el bileği veya parmak düşüklüğü ile başvuran 57 hasta retrospektif olarak değerlendirildi. Tüm hastalara median, ulnar ve radial sinirlerin motor ve duyu ileti çalışmaları ile birlikte radial sinir ve C7C8 kökleri tarafından innerve edilen kasların iğne elektromiyografisi EMG uygulandı. Radial sinir lezyonları üç düzeyde sınıflandırıldı: Düzey 1 triseps dalının proksimali, Düzey 2 triseps sonrası ve supinator öncesi, Düzey 3 posterior interosseöz sinir. Sinir hasarı aksonal veya demiyelinizan olarak kategorize edildi. 40ı erkek, 17si kadın olmak üzere toplam 57 hastanın 56sında radial sinir hasarı saptandı. En sık neden travma olup, bunu cerrahi ve kompresyona bağlı yaralanmalar izledi. Elektrofizyolojik bulgular, en sık tutulumun distal humerus ile ilişkili olan Düzey 2de görüldüğünü ortaya koydu. Düzey 1 yaralanmaları proksimal humeral lezyonlarla, Düzey 3 ise radius cismi ile ilişkili lezyonlarında sık izlendi. Tüm hastalarda aksonal hasar saptanmakla birlikte, olguların 49 unda kısmi, 28 inde total ve 23 belirgin kısmi aksonal hasar mevcuttu. Bulgularımız, travmaya bağlı radial sinir yaralanması izole distal ekstansör güçsüzlüğünün en önemli nedeni olduğunu göstermektedir. Lezyonların doğru lokalizasyonu, tanının kesinleştirilmesi ve uygun tedavi stratejilerinin belirlenmesi açısından elektrofizyolojik değerlendirme gereklidir.

Makale detayları

Evaluation of Patients Referred for Isolated Distal Upper Limb Extensor Weakness: A Retrospective Electrophysiological Study

Yazarlar:

Şeyma Aykaç | Seray İbiş Göksal | Abdullah Arı | Esra Aşıkdoğan | İbrahim Aydoğdu

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Nöroloji ve Nöromüsküler Hastalıklar

Dergi:

Osmangazi Tıp Dergisi Vol.47 Issue 6, pp.931-938

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350923

pISSN:

1305-4953

Wrist drop

finger drop

traumatic radial nerve injury

electromyographyDüşük el

düşük parmak

travmatik radial sinir hasarı

elektromyografi

Sayı

Makale detayları

Yazarlar: Şeyma Aykaç | Seray İbiş Göksal | Abdullah Arı | Esra Aşıkdoğan | İbrahim Aydoğdu

Yayıncı: Eskişehir Osmangazi University

Ana Başlıklar: Nöroloji ve Nöromüsküler Hastalıklar

Dergi: Osmangazi Tıp Dergisi Vol.47 Issue 6, pp.931-938

Belge Tipi: Makale

Yayın Tarihi: 9/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001350923

pISSN: 1305-4953

Sayı

Yazarlar:

Şeyma Aykaç | Seray İbiş Göksal | Abdullah Arı | Esra Aşıkdoğan | İbrahim Aydoğdu

Yayıncı:

Eskişehir Osmangazi University

Ana Başlıklar:

Nöroloji ve Nöromüsküler Hastalıklar

Dergi:

Osmangazi Tıp Dergisi Vol.47 Issue 6, pp.931-938

Belge Tipi:

Makale

Yayın Tarihi:

9/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001350923

pISSN:

1305-4953