A patient using axillary crutches develops wrist drop and loss of elbow extension on both sides after several weeks of unsupervised use. The most likely cause is compression of which structure?

• A Brachial plexus cords beneath the clavicle
• B Ulnar nerve in the cubital tunnel
• C Median nerve under the lacertus fibrosus
• D Radial nerve against the spiral groove of the humerus ✓

Explanation

Leaning on the axillary pad compresses the radial nerve where it lies directly on the humerus in the spiral groove, producing wrist drop and weak triceps, exactly this patient's findings. The correct technique transfers weight through the handpiece with two to three finger-breadths of space between the axilla and the pad. Ulnar nerve compression would cause clawing and intrinsic hand weakness, not wrist drop.

Reference: Maheshwari's Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.