Radial nerve palsy in the newborn: a report of four cases and literature review.

Background: Radial nerve palsy in the neonate is a rare clinical entity but must be distinguished from the more common brachial plexus birth palsy which occurs during the perinatal period. Although longer term upper-limb function following brachial plexus birth palsy is highly variable depending on the extent of neurological involvement, sparse reports of neonates with radial nerve palsy have nearly universal spontaneous recovery with normal upper-limb function.

Methods: We report 4 cases of patients born with findings consistent with radial nerve palsy.

Results: All 4 cases of neonatal radial nerve palsy supported a common etiology of intrauterine compression and resulted in spontaneous recovery of radial nerve function.

Conclusion: Neonatal radial nerve palsy should be suspected in newborns presenting with absent wrist and digital extension but intact deltoid, biceps, and triceps function with wrist and digital flexor function. The presence of ecchymosis and/or fat necrosis along the posterolateral brachium may support the notion that neonatal radial nerve palsy is caused by a compression injury during or before labor. Complete spontaneous recovery of radial nerve function may be anticipated if there is no associated infectious or constriction band pathology.