Compressive radial neuropathy induced by 'hooking' manoeuvre in a tetraplegic person.
METHODS
Case report.


OBJECTIVE
To describe a case of radial nerve compression neuropathy caused by a common wheelchair technique (hooking manoeuvre) used by a tetraplegic person to maintain truncal stability on a wheelchair.


METHODS
Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.


RESULTS
A 45-year-old man with American Spinal Injury Association Impairment Scale A C6 for the last 32 years developed progressive weakness of the right upper limb that was associated with pain in the shoulder and arm. Serial physical examinations demonstrated motor and sensory deterioration. Magnetic resonance imaging of the spinal cord showed no evidence of syringomyelia. Electrodiagnostic study showed motor and sensory neuropathy of the right radial nerve in the axillary region.


CONCLUSIONS
The act of hooking the arm behind the wheelchair push handle causes trauma leading to radial nerve compression neuropathy. Because this technique is used frequently by wheelchair users, future studies should examine the prevalence of radial neuropathy in this population and develop alternative methods to maintain balance on the wheelchair.
Julia
P E
PE
Department of Rehabilitation Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia. jpe242696@yahoo.com
Mazlina
M
M
Nazirah
H
H
D001132:Arm / Q000294:innervation / Q000503:physiopathology; D012090:Cumulative Trauma Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004568:Electrodiagnosis / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D011782:Quadriplegia / Q000150:complications* / Q000534:rehabilitation; D011826:Radial Nerve / Q000293:injuries* / Q000503:physiopathology*; D020425:Radial Neuropathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014910:Wheelchairs / Q000009:adverse effects*