Newborn With Bilateral Wrist Drop: A Rare Presentation of Isolated Radial Nerve Palsy

新生儿双侧腕下垂:孤立性桡神经麻痹的罕见表现

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Abstract

Isolated radial nerve palsy in newborns is rare, marked by impaired wrist and finger extension with preserved shoulder and elbow function. Differential diagnosis includes brachial plexus injuries and rare tumors. We present a case of a preterm infant, delivered by cesarean section after 35 weeks+5 days of uneventful pregnancy, who presented with bilateral wrist drop and asymmetrical skin lesions. Ultrasound revealed subcutaneous adipose necrosis in the left arm, suggesting radial nerve compression. Conservative management was initiated, focusing on passive mobilization and neurosensory stimulation. Over time, we observed a gradual recovery of wrist and finger extension bilaterally. Isolated radial nerve palsy in newborns usually presents a favorable prognosis, with spontaneous recovery typically occurring within six months. The early identification and differentiation of less serious conditions from more severe ones are crucial for effective management and for reassuring parents. Implementing early rehabilitation interventions, as demonstrated in the present case, can enhance recovery outcomes and mitigate the risk of musculoskeletal complications.

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