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Síndrome do Túnel Radial

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Radial tunnel syndrome — causes forearm pain, weakness straightening fingers, and is distinct from tennis elbow.

Updated Aug 2026
Ilustração de uma pessoa segurando a parte superior externa do antebraço devido à dor.
A síndrome do túnel radial causa dor surda no antebraço superior lateral, logo abaixo do cotovelo. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que você está sentindo

Você pode notar uma dor profunda e latejante na parte externa do cotovelo. Esse desconforto frequentemente irradia pela parte superior do antebraço em direção ao pulso e à mão. Diferente de outras questões neurológicas, você tipicamente não sente fraqueza na mão nesta fase. Em vez disso, o principal sintoma é uma dor persistente que pode ser difícil de localizar em um ponto específico.

A dor frequentemente piora quando você estende o pulso ou os dedos contra resistência. Você pode sentir um aumento da dor ao segurar objetos, girar uma maçaneta ou levantar itens com a palma da mão voltada para baixo. Atividades que exigem movimentos repetitivos do braço, como digitar ou jardinar, podem desencadear crises. A dor também pode se tornar mais perceptível à noite, dificultando a busca por uma posição confortável para dormir.

As tarefas diárias podem se tornar desafiadoras à medida que o desconforto aumenta. Ações simples, como alcançar as costas para fechar um sutiã ou abotoar uma camisa, podem causar pontadas agudas ou um latejar surdo. Você pode acabar evitando certos movimentos para proteger o braço, o que pode levar à rigidez ao longo do tempo. Embora o repouso frequentemente proporcione algum alívio, a dor pode persistir e interferir na sua rotina.

Se as medidas conservadoras não aliviarem seus sintomas, podemos discutir outras opções. Nossa abordagem foca em identificar a fonte da irritação para orientar sua recuperação. Nosso objetivo é ajudá-lo a recuperar o conforto e a função por meio de um plano personalizado às suas necessidades específicas.

O que está realmente acontecendo

A Síndrome do Túnel Radial ocorre quando o nervo radial é comprimido ao percorrer o seu braço. Este nervo atravessa uma passagem estreita no antebraço, conhecida como túnel radial. Imagine este túnel como uma manga apertada. Quando os tecidos ao redor incham ou se contraem, eles pressionam o nervo. Esta pressão impede que o nervo envie sinais claros aos seus músculos.

O nervo radial controla os músculos que levantam o seu punho e os dedos. Também fornece sensibilidade na parte posterior da mão. Quando o nervo está comprimido, você pode sentir uma dor profunda na parte externa do cotovelo e do antebraço. Esta dor frequentemente piora quando você tenta estender o punho contra resistência. Você também pode notar fraqueza na sua pegada ou dificuldade em levantar objetos. Estes sintomas ocorrem porque o nervo tem dificuldade em se comunicar com os seus músculos sob pressão.

O seu cirurgião procurará o ponto específico onde ocorre esta compressão. Não existe uma única abordagem cirúrgica que possa visualizar e liberar completamente todos os pontos potenciais de compressão no túnel radial. É por isso que o exame cuidadoso é vital. Se os tratamentos conservadores não ajudarem, a cirurgia pode ser recomendada para libertar o nervo. O objetivo é criar mais espaço para que o nervo possa se mover livremente novamente.

Em alguns casos, o problema está ligado a outros problemas do cotovelo. Por exemplo, a rigidez do cotovelo às vezes tem origem na irritação nervosa. Se você estiver passando por cirurgia para rigidez do cotovelo, o seu cirurgião verificará qualquer envolvimento neurológico. A liberação preventiva do nervo pode ser considerada mesmo que a função do seu nervo pareça normal antes da operação. Isso ajuda a prevenir complicações futuras e garante a melhor recuperação possível para o movimento e a força do seu braço.

O que podemos fazer a respeito

A abordagem adotada pelo Dr. Kieran Hirpara, cirurgião de membro superior do Mater Private Hospital Rockhampton, reflete como gerenciamos essa condição em nossa clínica. Geralmente, começamos com tratamento não cirúrgico. Esta primeira etapa concentra-se no repouso e nas alterações de atividade para reduzir a tensão no antebraço. A fisioterapia visa melhorar a força e a flexibilidade do braço e do pulso. Normalmente, recomendamos uma tentativa razoável deste tratamento conservador antes de considerar outras opções.

O manejo médico ajuda a controlar a dor e a inflamação enquanto você se recupera. Seu cirurgião pode sugerir medicamentos anti-inflamatórios para reduzir o inchaço ao redor do nervo. Em alguns casos, discutimos injeções. Injeções de cortisona podem acalmar a inflamação, embora o efeito seja temporário. Injeções de ácido hialurônico ou plasma rico em plaquetas (PRP) são outras opções que seu cirurgião pode discutir para apoiar a saúde dos tecidos. Esses tratamentos visam aliviar os sintomas e melhorar a função sem cirurgia.

A cirurgia é considerada quando o tratamento não cirúrgico não proporcionou melhora suficiente. Também recomendamos cirurgia imediatamente para problemas estruturais ou agudos, como lesão nervosa decorrente de fratura, sem uma tentativa prévia de tratamento não operatório. A descompressão cirúrgica envolve a liberação da pressão sobre o nervo radial. Esta é uma opção viável para casos que não respondem ao tratamento conservador. Em situações específicas, como dano nervoso causado por cimento durante a substituição do cotovelo, a remoção imediata do cimento e a liberação do nervo podem auxiliar na recuperação. Para lesões nervosas de longa data nas quais o nervo não pode ser reparado, podem ser utilizadas transferências tendinosas para restaurar a função da mão. Discutimos essas opções com você para garantir que o plano atenda às suas necessidades.

O que esperar

Para a maioria das pessoas, a síndrome do túnel radial melhora sem cirurgia. A recuperação espontânea ocorre em 70%–88% das lesões do nervo radial. Isso significa que é provável que seus sintomas diminuam por conta própria ao longo do tempo. O manejo inicial não cirúrgico é a primeira etapa padrão. Seu cirurgião o guiará por meio de tratamentos conservadores para ajudar na recuperação do seu nervo.

Se seus sintomas não melhorarem com o tratamento conservador, a cirurgia pode ser uma opção. A descompressão cirúrgica alivia a pressão sobre o nervo radial. Isso geralmente é reservado para casos que permanecem dolorosos apesar de outros tratamentos. O prognóstico após a cirurgia depende de vários fatores, incluindo há quanto tempo você apresenta sintomas e a causa específica da compressão do nervo.

A recuperação é um processo gradual. Se a cirurgia for necessária, seu cirurgião buscará aliviar a pressão sobre o nervo. Você pode notar mudanças na sensibilidade ou na força ao longo de semanas a meses. Em alguns casos, como lesões relacionadas a fraturas, a exploração cirúrgica precoce dentro de 3 semanas após a lesão pode aumentar a probabilidade de recuperar a função nervosa. No entanto, mesmo com a intervenção, a recuperação completa não é garantida para todos.

É importante ter expectativas realistas. Embora muitos pacientes apresentem melhora significativa, alguns podem continuar a ter sintomas residuais. O objetivo do tratamento é reduzir a dor e restaurar a função na maior medida possível. Seu cirurgião discutirá seu prognóstico específico com base na sua condição individual e na resposta aos tratamentos iniciais.

Se a lesão nervosa for grave ou de longa data, procedimentos adicionais, como transferências tendinosas, podem ser considerados. Essas cirurgias ajudam a restaurar a função redirecionando os tendões. Isso geralmente é um último recurso para lesões nervosas irreparáveis. No entanto, a maioria dos pacientes encontra alívio por meio de métodos não cirúrgicos ou descompressão padrão.

Estamos aqui para apoiá-lo em todas as etapas dessa jornada. Monitoraremos seu progresso de perto e ajustaremos seu plano de cuidados conforme necessário. Nosso objetivo é ajudá-lo a retornar às suas atividades diárias com o mínimo de desconforto. Sinta-se à vontade para fazer perguntas se tiver dúvidas sobre o que esperar a seguir.

Quando procurar ajuda médica

Consulte o seu médico de família se tiver dor persistente no cotovelo lateral ou no antebraço que não melhora com o repouso. Solicite uma avaliação especializada se notar fraqueza no pulso ou nos dedos, ou se os sintomas interferirem no seu sono ou no trabalho. A piora súbita da dor ou da dormência também exige atenção imediata. Embora muitas lesões do nervo radial se recuperem espontaneamente entre 3 a 5 meses, a avaliação precoce é fundamental. A exploração cirúrgica dentro de 3 semanas após a lesão está associada a uma probabilidade significativamente maior de recuperação da função do nervo radial em comparação com a espera. O tratamento não cirúrgico é a primeira linha de tratamento para a síndrome do túnel radial, mas a avaliação atempada garante que receba os cuidados adequados.

Reviewed by Dr Kieran Hirpara · 7 August 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [2].
  • The traditional clinical issue surrounding radial tunnel syndrome has been properly identifying it [1].
  • Radial tunnel syndrome is distinct from posterior interosseous nerve syndrome, though both are reviewed in the context of radial nerve pathology [8].
  • The Rule-of-Nine test effectively specifies the site of tenderness for the diagnosis of radial tunnel syndrome [4].
  • Nonsurgical management is considered first-line treatment for radial tunnel syndrome [3].
  • Surgical decompression remains a viable option for refractory cases of radial tunnel syndrome despite ongoing controversy regarding diagnosis and outcomes [3].
  • There is a tendency that surgical decompression of the radial tunnel might be effective in patients with radial tunnel syndrome [14].
  • Pain in patients with radial tunnel syndrome may be treated successfully by surgical decompression of the superficial branch of the radial nerve [11].
  • Corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome [5].
  • Surgical decompression of the median nerve or the anterior interosseous nerve (AIN) in the forearm is rarely indicated, and a prolonged nonsurgical approach is warranted in most cases [19].

Anatomy & Pathophysiology

  • It is important to understand the anatomic course and distribution of the radial nerve to make an accurate diagnosis [9].
  • The posterior interosseous nerve crosses the radial head midline and increases its distance from bony structures with supination of the forearm [26].
  • Supination increases the linear distance between the posterior interosseous nerve and the radial head, which should be considered to increase safe working volume during intra-articular procedures on the anterolateral aspect of the elbow [26].
  • The distance of the posterior interosseous nerve from the radial head appears to increase with forearm supination, potentially increasing safe working space [31].
  • Predictive accuracy for posterior interosseous nerve localization in the proximal forearm is highest when the arm is in a supinated position [32].
  • The posterior interosseous nerve moves farther from the radial head during elbow extension than flexion [35].
  • The posterior interosseous nerve moves farther from the radial head during forearm pronation than supination [35].
  • Distal migration of the posterior interosseous nerve is minimal (3.5 mm) across various elbow and forearm positions [35].
  • Wrist proprioception appears to be a multifactorial phenomenon [34].
  • There is controversy surrounding radial tunnel syndrome, dynamic compression theories, and the difficulty in differentiating it from tennis elbow [37].

Classification

  • Radial tunnel syndrome is traditionally defined as a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [7].
  • Radial tunnel syndrome and posterior interosseous nerve compression are distinct entities with different clinical presentations but share identical potential sites of nerve interference [12].
  • Radial tunnel syndrome and posterior interosseous nerve compression are proposed to be mild (radial tunnel syndrome) and severe (posterior interosseous nerve compression) forms of one disease to simplify nomenclature [12].
  • MR imaging features provide credence to the concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve [10].
  • The issue surrounding radial tunnel syndrome traditionally has been properly identifying it clinically [1].
  • It is important to understand the anatomic course and distribution of the radial nerve in order to make an accurate diagnosis [9].
  • Nomenclature advocates for consistent use of terminology distinguishing the deep branch of the radial nerve and the posterior interosseous nerve [17].
  • Radial tunnel syndrome and posterior interosseous nerve syndrome are recommended to be viewed as a single condition presenting along a spectrum of nerve entrapment [17].

Clinical Presentation

  • Radial tunnel syndrome is traditionally characterized by difficulty in proper clinical identification [1].
  • Radial tunnel syndrome is an illness construct based on speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis [2].
  • There is ongoing controversy regarding the diagnosis and outcomes of radial tunnel syndrome [3].
  • Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm [7].
  • Radial tunnel syndrome and posterior interosseous nerve compression are distinct entities with different clinical presentations [12].
  • Radial tunnel syndrome and posterior interosseous nerve compression share identical potential sites of nerve interference [12].
  • Radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve [10].
  • Understanding the anatomic course and distribution of the radial nerve is important for making an accurate diagnosis [9].
  • Radial tunnel syndrome and posterior interosseous nerve syndrome may be viewed as a single condition presenting along a spectrum of nerve entrapment [17].

Investigations

  • Radial tunnel syndrome is traditionally identified through clinical evaluation [1].
  • MR imaging provides credence to the concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve [10].
  • Dynamic ultrasonographic assessment of changes in the anteroposterior diameter and cross-sectional area is an effective diagnostic tool for identifying radial tunnel syndrome [18].
  • Neuroimaging should be considered as a complementary diagnostic method in posterior interosseous neuropathy syndrome [33].

Treatment

Non-Operative Management

  • Nonsurgical management is the first-line treatment for radial tunnel syndrome [3].
  • A prolonged nonsurgical approach is warranted in most cases of nerve compression syndromes in the forearm, such as ulnar tunnel syndrome, radial tunnel syndrome, anterior interosseous nerve syndrome, and pronator syndrome [19].
  • Nonoperative management with corticosteroid injection can be used as a therapeutic measure with potential long-term benefits in the treatment of radial tunnel syndrome [27].
  • Prospective evaluation of a single corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome [5].

Operative Management

  • Surgery is advocated for high radial nerve entrapment neuropathy cases resistant to conservative treatment, emphasizing the importance of dissecting the entire length of the fibrous tunnel [6].
  • No single surgical approach was adequate for complete visualization and release of all compression points of the radial tunnel [13].

Complications

  • Isolated posterior interosseous nerve neurectomy (PINN) has shown excellent clinical outcomes, with few patients experiencing recurrent pain at long-term follow-up [21].

Recovery

  • Surgical decompression is a viable option for refractory cases of radial tunnel syndrome [3].
  • In a case of posterior interosseous-nerve syndrome secondary to rheumatoid synovitis with entrapment duration of more than two years, a tendon transfer was used as treatment [38].
  • Surgical excision can lead to rapid recovery of nerve sensation in cases of radial nerve compression by ganglion cysts [39].

Key Evidence

  • [L5] The issue surrounding radial tunnel syndrome traditionally has been properly identifying it clinically. [1] (10.1097/01.bth.0000231580.32406.71)
  • [L5] Radial tunnel syndrome is an illness construct based on a speculative pathophysiology with no verifiable pathophysiology or accepted reference standard for diagnosis. [2] (10.1016/j.jhsa.2010.03.020)
  • [L4] The article reviews the anatomy, diagnosis, and treatment of radial tunnel syndrome, noting that while nonsurgical management is first-line, surgical decompression remains a viable option for refractory cases despite ongoing controversy regarding diagnosis and outcomes. [3] (10.5435/jaaos-d-23-00314)
  • [L4] The Rule-of-Nine test effectively specifies the site of tenderness for the diagnosis of radial tunnel syndrome. [4] (10.1177/230949900401200115)
  • [L4] Prospective evaluation of corticosteroid injection demonstrated improvement in standardized outcomes measures of pain and function at one year in 75% of patients presenting with symptoms of radial tunnel syndrome. [5] (10.1016/j.jhsa.2017.06.095)
  • [Case_report] The authors advocate for surgery in high radial nerve entrapment neuropathy cases resistant to conservative treatment, emphasizing the importance of dissecting the entire length of the fibrous tunnel. [6] (10.1016/j.jse.2025.02.060)
  • [L5] Radial tunnel syndrome is a pain syndrome caused by compression of the posterior interosseous nerve at the proximal forearm. [7] (10.1016/j.ocl.2012.07.022)
  • [Paper] This article is a review of the history, anatomy, and clinical presentation of radial tunnel syndrome (RTS) and posterior interosseous nerve syndrome (PINS). [8] (10.1016/s0749-0712(21)00357-7)
  • [L5] It is important to understand the anatomic course and distribution of the radial nerve in order to make an accurate diagnosis. [9] (10.1007/s11420-011-9238-8)
  • [L4] The study provides credence to the somewhat disputed concept that radial tunnel syndrome is a distinct clinical entity related to compression of the posterior interosseous nerve. [10] (10.1148/radiol.2401050028)
  • [L4] This study indicates that pain in patients with radial tunnel syndrome may be treated successfully by surgical decompression of the superficial branch of the radial nerve. [11] (10.1177/1753193408099832)
  • [L5] Radial tunnel syndrome (RTS) and posterior interosseous nerve (PIN) compression are distinct entities with different clinical presentations but share identical potential sites of nerve interference; the author proposes unifying them as mild (RTS) and severe (PIN compression) forms of one disease to simplify nomenclature. [12] (10.1177/1753193420953990)
  • [L5] No single approach was adequate for complete visualization and release of all compression points of the radial tunnel. [13] (10.1016/j.jhsa.2015.03.009)
  • [L4] There is a tendency that surgical decompression of the radial tunnel might be effective in patients with RTS. [14] (10.1016/j.jhsa.2007.10.001)
  • [L5] The authors advocate for consistent use of the terminology distinguishing the deep branch of the radial nerve (DBRN) and the posterior interosseous nerve (PIN), and recommend viewing radial tunnel syndrome and posterior interosseous nerve syndrome as a single condition presenting along a spectrum of nerve entrapment. [17] (10.1177/17531934241254706)
  • [L4] Dynamic ultrasonographic assessment of changes in the AP diameter and CSA is an effective diagnostic tool for identifying radial tunnel syndrome. [18] (10.1177/17531934261443138)
  • [L5] Surgical decompression of the median nerve or the AIN in the forearm is rarely indicated; a prolonged nonsurgical approach is warranted in most cases. [19] (10.5435/jaaos-d-16-00010)
  • [L4] Isolated PINN have shown excellent clinical outcomes, with few patients experiencing recurrent pain at long-term follow-up. [21] (10.1177/1558944717692093)
  • [L5] Supination increases the linear distance between the PIN and radial head and should be considered to increase the safe working volume whenever intra-articular procedures are performed on the anterolateral aspect of the elbow. [26] (10.1016/j.jse.2018.08.019)
  • [L4] Nonoperative management with corticosteroid injection can be used as a therapeutic measure with potential long-term benefits in the treatment of RTS. [27] (10.1177/1558944718787282)
  • [L5] Furthermore, its distance from the radial head appears to increase with forearm supination, which could increase the safe working space. [31] (10.1055/s-0037-1605388)
  • [L5] Predictive accuracy was highest when the arm was in a supinated position. [32] (10.1016/j.arthro.2013.03.056)
  • [L4] Neuroimaging should be considered as a complementary diagnostic method in PINS. [33] (10.1212/wnl.0000000000003287)
  • [L1] Wrist proprioception appears to be a multifactorial phenomenon. [34] (10.1016/j.jht.2015.03.003)
  • [L3] The posterior interosseous nerve moved farther from the radial head during elbow extension than flexion and during forearm pronation than supination, but distal migration was minimal (3.5 mm). [35] (10.5397/cise.2024.00213)
  • [L5] The paper is a letter to the editor discussing the controversy surrounding radial tunnel syndrome, dynamic compression theories, and the difficulty in differentiating it from tennis elbow, noting that a combined operative procedure for both conditions will be reported in the future. [37] (10.2106/00004623-199274020-00024)
  • [L4] In the third patient, in whom the duration of entrapment was more than two years, a tendon transfer was used as treatment. [38] (10.2106/00004623-197355040-00009)
  • [L4] Surgical excision can lead to rapid recovery of nerve sensation in cases of radial nerve compression by ganglion cysts. [39] (10.1007/s11552-007-9083-x)

References

[1] A Unified Approach to Radial Tunnel Syndrome and Lateral Tendinosis. Techniques in Hand & Upper Extremity Surgery. 2006. DOI: 10.1097/01.bth.0000231580.32406.71

[2] Radial Tunnel Syndrome. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.03.020

[3] Radial Tunnel Syndrome: Review and Best Evidence. Journal of the American Academy of Orthopaedic Surgeons. 2023. DOI: 10.5435/jaaos-d-23-00314

[4] A New Clinical Test for Radial Tunnel Syndrome—The Rule-of-Nine Test: A Cadaveric Study. Journal of Orthopaedic Surgery. 2001. DOI: 10.1177/230949900401200115

[5] Prospective Evaluation of Single Corticosteroid Injection in Radial Tunnel Syndrome. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.06.095

[6] High radial nerve entrapment neuropathy: an anatomical cadaver study and case report. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2025.02.060

[7] Radial Tunnel Syndrome. Orthopedic Clinics of North America. 2012. DOI: 10.1016/j.ocl.2012.07.022

[8] RADIAL TUNNEL SYNDROME. Hand Clinics. 1996. DOI: 10.1016/s0749-0712(21)00357-7

[9] Posterior Interosseous Neuropathy: Electrodiagnostic Evaluation. HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery. 2012. DOI: 10.1007/s11420-011-9238-8

[10] MR Imaging Features of Radial Tunnel Syndrome: Initial Experience. Radiology. 2006. DOI: 10.1148/radiol.2401050028

[11] Radial Tunnel Syndrome: Emphasis on the Superficial Branch of the Radial Nerve. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408099832

[12] Radial tunnel syndrome: definition, distinction and treatments. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420953990

[13] Anatomical Study of the Surgical Approaches to the Radial Tunnel. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.03.009

[14] Interventions for Treating the Radial Tunnel Syndrome: A Systematic Review of Observational Studies. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.10.001

[17] Nomenclature of the radial nerve: distinguishing between the deep branch of the radial nerve and the posterior interosseous nerve. Journal of Hand Surgery (European Volume). 2024. DOI: 10.1177/17531934241254706

[18] Role of high-resolution dynamic ultrasonography in the evaluation of posterior interosseous nerve compression at radial tunnel: a prospective case-control study. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934261443138

[19] Ulnar Tunnel Syndrome, Radial Tunnel Syndrome, Anterior Interosseous Nerve Syndrome, and Pronator Syndrome. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-16-00010

[21] Outcomes Following Isolated Posterior Interosseous Nerve Neurectomy: A Systematic Review. HAND. 2017. DOI: 10.1177/1558944717692093

[26] The posterior interosseous nerve crosses the radial head midline and increases its distance from bony structures with supination of the forearm. Journal of Shoulder and Elbow Surgery. 2019. DOI: 10.1016/j.jse.2018.08.019

[27] Prospective Evaluation of a Single Corticosteroid Injection in Radial Tunnel Syndrome. HAND. 2018. DOI: 10.1177/1558944718787282

[31] Distance of the Posterior Interosseous Nerve from the Radial Head during Elbow Arthroscopy: An Anatomical Study. Joints. 2017. DOI: 10.1055/s-0037-1605388

[32] Posterior Interosseous Nerve Localization in the Proximal Forearm: A Cadaveric Study Establishing a Non‐invasive, Patient‐normalized Parameter (SS‐49). Arthroscopy. 2013. DOI: 10.1016/j.arthro.2013.03.056

[33] Posterior interosseous neuropathy. Neurology. 2016. DOI: 10.1212/wnl.0000000000003287

[34] Multiplanar wrist joint proprioception: The effect of anesthetic blockade of the posterior interosseous nerve or skin envelope surrounding the joint. Journal of Hand Therapy. 2015. DOI: 10.1016/j.jht.2015.03.003

[35] In vivo dynamic migration of the posterior interosseous nerve across various elbow and forearm positions. Clinics in Shoulder and Elbow. 2024. DOI: 10.5397/cise.2024.00213

[37] Radial tunnel syndrome. An investigation of compression neuropathy as a possible cause.. The Journal of Bone & Joint Surgery. 1992. DOI: 10.2106/00004623-199274020-00024

[38] Posterior Interosseous-Nerve Syndrome Secondary to Rheumatoid Synovitis. The Journal of Bone & Joint Surgery. 1973. DOI: 10.2106/00004623-197355040-00009

[39] Compression Neuropathy of the Radial Nerve Due to Ganglion Cysts. HAND. 2008. DOI: 10.1007/s11552-007-9083-x

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By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.