Hand Conditions

Tendon and Nerve Injuries

Wartenberg Syndrome

Definition:

Compressive neuropathy of the superficial sensory radial nerve within the muscles of the forearm (brachioradialis and the extensor carpi radialis longus) that creates pain and paresthesia (burning or prickling sensation) over the thumb side (dorsal-radial aspect) of the wrist and/or hand.

Symptoms:

  • Ill-defined pain over the back-side (dorsoradial) of hand
  • Numbness, burning and/or prickly sensation
  • Symptoms increase with wrist flexion and hammering motion (ulnar deviation)
  • No motor deficits

Pathology:

  • Compression of the sensory radial nerve due to scissoring action between the brachioradialis and the extensor carpi radialis longus
  • Associated with de Quervain’s disease
  • Associated history with forearm fractures, handcuffs, fracture casting, and tight jewelry/wrist bands.

Treatment:

Non-surgical

  • Rest, activity modifications, removable splint, ice and NSAIDs (ibuprofen)
  • Avoid tight/compressive watchbands and/or jewelry about the wrist.

Surgical

  • Indicated when non-operative treatment fails.
  • Surgical decompression of the nerve.