Bilateral transient radial nerve palsies in an infant after cardiac surgery

Purpose: To describe the case of an infant who suffered bilateral transient radial nerve palsies after cardiac surgery. Clinical features: A one-month-old baby was found to have bilateral wrist a nd finger drop after the removal of splints that has been applied to the ri ght hand for 14 days and to the right hand for six days during perioperativ e management of Blalock-Taussig shunt surgery. The hand splints had been ap plied to the forearms with adhesive silky tape to keep peripheral vascular lines in place. The patient also suffered from several episodes of cardioge nic shock, hypoxemia and generalized edema relating to cardiac dysfunction during this tine period, Given the findings of no impairment of median or u lnar nerves and brachioradial muscle, it was suspected that bandaging with adhesive tapes caused peripheral radial nerve damage at the level of poster ior interosseus nerve on forearm, Diminished oxygen delivery and edema may additionally have contributed to peripheral nerve ischemia. The aforementio ned neurologic symptoms resolved spontaneously after several days. Conclusion: Prolonged compression by bandaging of splints on forearm may ha ve resulted in ischemic damage to the posterior interosseus nerve branch co mbined with extensor carpi radialis longus nerve branch the radial nerve. W e should attempt to reduce the frequency and duration of splinting of the e xtremities, especially in sedated, paralyzed babies, given the potential ri sk of compression neuropathy.