Peripheral nerve palsy by torsional nerve injury.
BACKGROUND
Peripheral nerve palsy caused by torsional nerve injury is rare. Only a few patients have been reported in the literature. The etiology of this type of nerve lesion is poorly understood.


OBJECTIVE
To report on 5 patients presenting with peripheral nerve palsy caused by a torsional nerve injury.


METHODS
Five patients presented with 6 upper peripheral nerve palsy involving the axillary nerve (n = 2), musculocutaneous nerve (n = 2), radial nerve (n = 1), and suprascapular nerve (n = 1). There was no history of trauma in 3 patients, but in the other 2 patients, nerve palsy occurred after a traumatic event. Because of a lack of spontaneous recovery, surgical exploration was performed. Torsion of the whole nerve (n = 5) or only 1 fascicle (n = 1) was found. Epifascicular epineurectomy and detorsion, as well as resection of the torsion site with subsequent primary nerve suture, were performed in 3 lesions.


RESULTS
Good to excellent recovery of motor function was achieved in all 5 patients. In the last patient who presented with 2 nerve torsions, the follow-up period after the last surgery is too short to allow evaluation.


CONCLUSIONS
Although not a frequent event, torsional nerve injury should be taken into consideration when dealing with peripheral nerve injuries. Surgical exploration with detorsion or suture results in good recovery.
Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald, Germany. kleist-w@uni-greifswald.de
Waltraud Kleist-Welch
WK
Guerra
Henry W S
HW
Schroeder
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009138:Musculocutaneous Nerve / Q000293:injuries* / Q000601:surgery; D010243:Paralysis / Q000175:diagnosis* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000601:surgery; D011826:Radial Nerve / Q000293:injuries* / Q000601:surgery; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult