Summary

Patient has chief complain couldn’t straighten her left fingers and thumb since

5 months ago. She felt from stairs at January 2016 and she went to bone setter

because of pain on his forearm. During 3 months she controlled in bone setter and

had massage from there. On February 2017 she complained pain again and went to

orthopaedic outpatient clinic at Universitas Airlangga hospital and Xray result was

fracture nonunion. She got surgery at March 10th, 2017, then her forearm looked

normal, but 1 month later her left fingers started couldn’t straight. There was tingling

sensation if she bend her elbow for a long time. There was a tenderpoint in elbow

(wound area). From Physical Examination, we found weakness of M. Brachioradialis,

M. Extensor Carpi Radialis Longus, M. Extensor Carpi Radialis Brevis, M.

Supinator, M. Extensor Carpi Ulnaris, M. Extensor Digitorum Communis, M.

Extensor Digiti Minimi, M. Abductor Policis Longus, M. Extensor Policis Longus,

M. Extensor Policis Brevis, and M. Extensor Indicis Proprius. Motoric of the other

muscle within normal limit. Sensory examination of Radial, Median, and Ulnar nerve

dermatome within normal limit. Patient also had weak functional in Spherical, pinch,

and lateral tip hand function. EMG result showed that aksonal lesion on left radial

nerve distal level from branch to Brachioradialis muscle until proximal Extensor

Carpi Radialis Longus muscle with partial denervation sign on Extensor Indicis

muscle and Extensor Carpi radialis Longus muscle.

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 We diagnosed this patient with Left Radial Nerve Lesion. The treatment goal

for this patient divided to short term and long term goal. Short term goal are decrease

pain, improve sensory deficit, muscle strength, and decrease anxiety. Long term goal

are improve hand function for ADL and go back to her activities as student.

Physical Medicine and Rehabilitation management include explanation of her

disease, Electrostimulation on left Extensor digitorum muscle, extensor pollicis

longus and brevis muscle, Abductor Policis Longus muscle, hand function exercise,

finger extensor muscle, wrist, and brachioradialis strengthening, ROM exercise of left

finger, and sensory resensitization of left upper extremity.

Based on progress note, there is improved on muscle strength of M.

Brachioradialis , M. Supinator, M. Extensor digiti minimi, and M. Abductor Policis

Longus on the left upper extrimity. For the sensoric, there is decrease of sensory

deficit and pain.

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