Crutch palsy refers to radial nerve injury at which location?

• A. Axilla
• B. Mid-humeral shaft
• C. Elbow
• D. Wrist

Answer: (A)

Crutch palsy occurs when prolonged pressure from crutches compresses the radial nerve in the axilla. In the armpit region, the nerve is vulnerable as it crosses the axilla, so squeezing against the soft tissues during crutch use disrupts its motor fibers to the extensor muscles and its sensory fibers to parts of the dorsum of the hand. This pattern leads to weakness of wrist and finger extension (wrist drop) and sometimes elbow extension, with sensory changes over the radial side of the hand. Other radial nerve injuries can happen at the mid-humeral shaft, around the elbow, or at the wrist, but crutch palsy specifically denotes axillary compression from crutch use, which is why the axilla is the correct location.