Unless there is loss of motor function, treatment is conservative in the initial period. Wrist extension splints with the elbow flexed and supinated provides maximal relief in radial tunnel syndrome. Surgical exploration is indicated if conservative measures fail after 3 to 6 months. Tell Rodney he is remembering Wartenburg s syndrome. This syndrome was described in 1932 as an isolated neuritis of the superficial sensory branch of the radial nerve that produces persistent pain on the dorsal surface of the wrist and the distal forearm.
Treatment consists of removing all sources of external compression of the nerve.
Surgical decompression is indicated for persistent symptoms that do not improve within 3 months. Injection of this area with lidocaine is a helpful diagnostic maneuver. Your last patient for that day is Adam Beaner, a 39 year old auto assembly worker, who has all the symptoms of carpal tunnel syndrome except he has numbness in the entire palm and fingers. Rodney is totally confused. In some patients, the congenital variation of innervation is such that the entire palm and all five digits receive sensory supply from just median or just ulnar nerve.