Radial nerve palsy in the newborn combined with congenital radial head dislocation: Case report and literature review

Abstract

Rationale: Radial nerve palsy in the newborn and congenital radial head dislocation (CRHD) are both rare disorders, and early diagnosis is challenging. We reported a case of an infant with concurrent presence of these 2 diseases and provide a comprehensive review of the relevant literature. The purpose of the study is to share diagnostic and treatment experiences and provide potentially valuable insights. Patient concerns: A newborn has both radial nerve palsy and CRHD, characterized by limited wrist and fingers extension but normal flexion, normal shoulder and elbow movement on the affected side, characteristic skin lesions around the elbow, and an “audible click” at the radial head. The patient achieved significant improvement solely through physical therapy and observation. Diagnoses: The patient was diagnosed with radial nerve palsy in the newborn combined with CRHD. Interventions: The patient received regular physical therapy including joint function training, low-frequency pulse electrical therapy, acupuncture, paraffin treatment, as well as overnight splint immobilization. Outcomes: The child could actively extend the wrist to a neutral position and extend all fingers. Lessons: If a neonate exhibits limited extension in the wrist and fingers, but normal flexion, along with normal shoulder and elbow movement, and is accompanied by skin lesions around the elbow, there should be a high suspicion of radial nerve palsy in the newborn.