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Am Fam Physician ; 103(5): 275-285, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33630556

RESUMEN

Peripheral nerves in the upper extremities are at risk of injury and entrapment because of their superficial nature and length. Injury can result from trauma, anatomic abnormalities, systemic disease, and entrapment. The extent of the injury can range from mild neurapraxia, in which the nerve experiences mild ischemia caused by compression, to severe neurotmesis, in which the nerve has full-thickness damage and full recovery may not occur. Most nerve injuries seen by family physicians will involve neurapraxia, resulting from entrapment along the anatomic course of the nerve. In the upper extremity, the brachial plexus branches into five peripheral nerves, three of which are commonly entrapped at the shoulder, elbow, and wrist. Patients with nerve injury typically present with pain, weakness, and paresthesia. A detailed history and physical examination alone are often enough to identify the injury or entrapment; advanced diagnostic testing with magnetic resonance imaging, ultrasonography, or electrodiagnostic studies can help confirm the clinical diagnosis and is indicated if conservative management is ineffective. Initial treatment is conservative, with surgical options available for refractory injuries or entrapment caused by anatomic abnormality.


Asunto(s)
Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/fisiopatología , Síndromes de Compresión Nerviosa/terapia , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Enfermedades del Sistema Nervioso Periférico/terapia , Extremidad Superior/lesiones , Extremidad Superior/fisiopatología , Adulto , Curriculum , Educación Médica Continua , Femenino , Personal de Salud/educación , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto
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