radial nerve palsy

see also:

• paraesthesiae or numbness

• atraumatic radial nerve palsy is usually due to prolonged pressure on the nerve as it passes around the humeral mid-shaft
• the most common cause is the intoxicated patient sleeping on a chair with their arm over the back of the chair
• results in wrist drop

• remove the cause if still present (eg. compression from a plaster cast)
• provide volar splint with some wrist extension, either
  • POP volar slab
    • tends to provide more support and especially useful for patients with sensory changes for whom the factory splint can be irritating
  • factory splint
    • can be obtained from Plaster Technicians
• refer to Occupational Therapy
  • at Western Health:
    • complete the purple Allied Health form
    • contact Senior Hand Occupation Therapist Angela Chu (by page or phone) to inform her of the referral (she will chase up)
    • refer to a parent inpatient team
      • OT needs a medical team to refer back to if the condition does not improve
      • best choice would be Neurology for atraumatic palsies
      • does not matter if their appointment is not going to be for months, as long as they have a referral
    • points to make note of:
      • there is no such thing as “Hand Clinic” at Western Health for non-trauma cases to book an appointment into
      • OT do not accept referrals from GPs therefore do not refer back to GP for OT referral – there must be an internal referral
      • OT provide a therapy/management service and not a diagnostic service … do not send unusual hand things to OT for “hand therapy”
      • please provide adequate detail on the referral to OT to avoid them having to chase you up
    • patients with chronic, long standing radial nerve palsy can be referred to Community Based Rehab (CBR) either via Care Coordination or via their GP.