Robert Wartenberg Syndrome and Sign: A Review Article

Abstract

Background: Robert Wartenberg, a European-American neurologist, was born in 1887 and died in 1956. His description of radial sensory nerve compression at the forearm is memorialized as Wartenberg’s syndrome. He recognized that involuntary abduction of the little finger could be caused by ulnar nerve palsy - a finding often called Wartenberg’s sign Syndrome and signs are reviewed, and a brief biography is presented. Objective: To review Wartenberg’s sign and Wartenberg’s syndrome. Discussion: Compression of the superficial branch of the radial nerve, often called Wartenberg’s syndrome, is characterized by pain, paresthesia, and dysesthesia along the dorsoradial distal forearm. Non-operative treatment can include activity restriction and anti-inflammatory medication. If symptoms persist, surgical decompression of the radial nerve is an option. The abducted posture of the little finger - Wartenberg’s sign - can result from a low ulnar nerve palsy. Tendon transfer can be performed to correct this deformity. Conclusion: Compression of the superficial branch of the radial nerve and abducted posture of the little finger were described by Robert Wartenberg and carry his name as eponymous syndrome and sign, respectively.

Upper Limb Nerve Variations May Alter Clinical Diagnosis: A Scoping Review

“…The incidence of Wartenberg's syndrome, the entrapment or compression of the superficial radial nerve, an exclusively sensory nerve, is not known (Kuschner & Berihun, 2021). The radial nerve descends in the cubital fossa region, splitting into the posterior interosseous nerve (the motor branch) and the superficial nerve (the sensory branch).…”

“…The sensory branch runs superficial to the supinator muscle, along the ulnar edge, and deep to the brachioradialis muscle. After that, it becomes subcutaneous between the brachioradialis muscle and the tendon of the extensor carpi radialis longus muscle (Kuschner & Berihun, 2021). This nerve has been reported to be the most vulnerable to compression where it travels from deep to superficial, at the edge of the brachioradialis muscle (Kuschner & Berihun, 2021).…”

“…After that, it becomes subcutaneous between the brachioradialis muscle and the tendon of the extensor carpi radialis longus muscle (Kuschner & Berihun, 2021). This nerve has been reported to be the most vulnerable to compression where it travels from deep to superficial, at the edge of the brachioradialis muscle (Kuschner & Berihun, 2021). However, when the superficial branch of the radial nerve pierces through the brachioradialis muscle this variant course may predispose the nerve to compression neuropathy (Tryfonidis et al, 2004).…”

Eponyms Describing Soft Tissue Pathologies in Orthopedic Hand Surgery

“…In 1932, Wartenberg described five cases of mononeuropathy of the superficial branch of the radial nerve, which he named "cheiralgia paresthetica" or hand pain [9]. Superficial radial nerve palsy, superficial radial nerve compression, and cheiralgia paresthetica are synonymous with what is now often called Wartenberg's syndrome [9].…”

Etiological study of superficial radial nerve neuropathy: series of 34 patients

“…Focal neuropathy of the superficial radial nerve (SRN) causes pain, burning, numbness, tingling, and dysesthesias of the dorsolateral aspect of the distal forearm and hand involving the dorsolateral three and a half fingers extending to the distal interphalangeal joint (1)(2)(3)(4)(5)(6). Initially reported in a patient with wrist watch compression in 1926 by Schlesigner and Matzdorff, this condition was later referred to as Wartenberg's syndrome after Wartenberg described 5 patients in 1932 with neuropathy involving the SRN (1-4, 7, 8).…”