Pediatric radial mononeuropathies: A clinical and electromyographic study of sixteen children, with review of the literature

Sixteen pediatric radial mononeuropathies were seen among 2077 electromyograms performed in the electromyography laboratory at The Children's Hospital, Boston, during 16.5 years, 1979-1995. Eight (50%) of these radial neuropathies, including 2 in newborns with apparent prenatal onset, were atraumatic, primarily related to compression in 6 and entrapment in 2. The other 8 (50%) were traumatic related to fractures or lacerations. Electromyography documented the radial neuropathy to be localized to the proximal main radial nerve trunk in 2 (13%), distal main radial nerve trunk in 9 (56%), and posterior interosseous nerve in 5 (31%) children. Significant improvement was noted in 13 of the 16 radial neuropathies--within 6-12 weeks for demyelinating lesions and up to 17 months for axonal injuries. Rarely, a child with a chronic progressive radial neuropathy or a postfracture radial neuropathy that does not improve in 3 months may require exploration.