ANTERIOR INTEROSSEOUS NERVE SYNDROME

Hand Surgery ◽  
1998 ◽  
Vol 03 (01) ◽  
pp. 57-62 ◽  
Author(s):  
Gary L. Arishita ◽  
Tsu-Min Tsai
Keyword(s):  
Conservative Treatment ◽  
Upper Extremity ◽  
Surgical Decompression ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Pronator Quadratus ◽  
Steroid Injections ◽  
Anterior Interosseous Nerve ◽  
Anterior Interosseous Nerve Syndrome ◽  
Flexor Digitorum

The anterior interosseous nerve syndrome was first described in 1948. It comprises less than 1% of all upper extremity nerve palsies. Patients have a characteristic pinch deformity, with paralysis or weakness of the muscles innervated by the anterior interosseous nerve, flexor pollicis longus, radial portion of the flexor digitorum profundus, and pronator quadratus. Electromyograms are positive in most patients presenting with motor complaints. Treatment is related to the specific etiology. Conservative treatment includes avoidance of strenuous forearm work, immobilization, steroid injections, and anti-inflammatory medications. If the presentation suggests nerve compression, and the EMG reveals evidence of axonal interruption, then surgical decompression should be performed. We present a series of six patients seen over a 7-year period. Improvement was noted in all the patients postoperatively.

An Anomaly of the Median Artery Associated with the Anterior Interosseous Nerve Syndrome

1992 ◽  
Vol 17 (5) ◽  
pp. 507-509 ◽  
Author(s):  
T. W. PROUDMAN ◽  
P. J. MENZ
Keyword(s):  
Flexor Digitorum Profundus ◽  
Vascular Compression ◽  
Pronator Quadratus ◽  
Pronator Teres ◽  
Longus Muscle ◽  
Anterior Interosseous Nerve ◽  
Median Artery ◽  
Anterior Interosseous Nerve Syndrome ◽  
Pronator Quadratus Muscle ◽  
Flexor Digitorum

The anterior interosseous nerve syndrome is characterized by paralysis of the flexor pollicis longus muscle, the flexor digitorum profundus muscle to the index and middle fingers, and the pronator quadratus muscle. The most common cause is entrapment of the anterior interosseous nerve near its origin from the median nerve by a variety of structures. Compression is most frequently caused by the deep head of the pronator teres muscle, or the fibrous arcade of the flexor digitorum superficialis muscle. Vascular compression has been reported infrequently. A patient with anterior interosseous nerve syndrome was found at operation to have the median artery passing through the anterior interosseous nerve just below the elbow. This artery has not previously been associated with the syndrome. A cadaver dissection confirmed the relationship.

Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis

1999 ◽  
Vol 90 (6) ◽  
pp. 1053-1056 ◽  
Author(s):  
Alexander Joist ◽  
Uwe Joosten ◽  
Dirk Wetterkamp ◽  
Michael Neuber ◽  
Axel Probst ◽  
...  
Keyword(s):  
Index Finger ◽  
Interphalangeal Joint ◽  
Nerve Compression ◽  
Flexor Digitorum Profundus ◽  
Pronator Quadratus ◽  
Motor Branch ◽  
Content Type ◽  
Anterior Interosseous Nerve ◽  
Anterior Interosseous Nerve Syndrome ◽  
Fine Print

Object. The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss.Methods. The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children. They have added a new case identified in a 7-year-old boy in whom a diagnosis was made from the clinical findings and whose treatment and outcome are analyzed. The ages of patients reported in the literature ranged from 4 to 10 years. Ten patients (29%) were treated with closed reduction and application of a cast, whereas 25 patients (71%) were treated with open reduction and fixation of the fracture.Conclusions. All patients regained full flexion and strength after 4 to 17 weeks. The fractures that were surgically treated showed no entrapment of the anterior interosseous nerve.

scholarly journals PRESENCE OF TRIPLE GANTZER'S MUSCLE - A RARE ANATOMICAL VARIATION

2013 ◽  
Vol 03 (01) ◽  
pp. 69-71
Author(s):  
Soubhagya R. Nayak ◽  
Suranjali Sharma ◽  
Hasi Dasgupta ◽  
Kalyan Bhattacharya
Keyword(s):  
Anatomical Variation ◽  
Flexor Digitorum Profundus ◽  
Neurovascular Compression ◽  
Peripheral Nerve Disorder ◽  
Anterior Interosseous Nerve ◽  
Male Cadaver ◽  
Clinically Significant ◽  
Anterior Interosseous Nerve Syndrome ◽  
Flexor Digitorum ◽  
Forearm Flexor

AbstractAnomalous muscles usually do not result in adverse symptoms but are of academic interest. However, these muscles can create neurovascular compression at times. Muscle anomalies of the upper extremity are recognized causes of peripheral nerve disorder. Koloh-Nevin Syndrome (Anterior Interosseous Nerve Syndrome) caused by the compression neuropathy of the anterior interosseous nerve in the forearm is believed to occur because of its compression by the accessory heads of flexor pollics longus (FPLah) and flexor digitorum profundus (FDPah). The above two accessory muscles are also called Gantzer's muscle. During routine cadaveric dissection, we encountered multiple Gantzer's muscles in a 60 year-old- formalin embalmed male cadaver. Along with the usual FPLah and FDPah described by Gantzer, we too observed an accessory muscle in relation to the flexor digitorum superficialis (FDS). All the three anomalous muscles had a common origin from the under cover of the FDS fibers and by fibrous band above the insertion of brachialis. The presence of multiple additional muscles in the forearm flexor compartment is rare and clinically significant.

Neurotization as an alternative for restoring finger and wrist extension

2001 ◽  
Vol 94 (5) ◽  
pp. 795-798 ◽  
Author(s):  
Mehmet Erkan Üstün ◽  
Tunç Cevat Öğün ◽  
Mustafa Büyükmumcu
Keyword(s):  
Median Nerve ◽  
Motor Nerve ◽  
Flexor Digitorum Profundus ◽  
Posterior Interosseous Nerve ◽  
Flexor Pollicis Longus ◽  
Pronator Quadratus ◽  
Content Type ◽  
Pronator Teres ◽  
Flexor Digitorum ◽  
Fine Print

Object. In cases of irreparable injuries to the radial nerve or in cases in which nerves are repaired with little anticipation of restoration of function, tendon transfers are widely used. In this study, the authors searched for a more natural alternative for selectively restoring function, with the aid of a motor nerve transfer. Methods. Ten arms from five cadavers were used in the study. The posterior interosseous nerve and the median nerve together with their motor branches were exposed in the proximal forearm. The possibility of posterior interosseous nerve neurotization via the median nerve through its motor branches leading to the pronator teres, flexor pollicis longus, flexor digitorum profundus, and pronator quadratus muscles was investigated. The lengths of the nerves from points of divergence and their widths were measured using calipers, and the means with standard deviations of all nerves were calculated. Motor branches to the pronator teres, flexor pollicis longus, and pronator quadratus muscles were found to be suitable for neurotization of the posterior interosseous nerve at different levels and in various combinations. The motor nerve extending to the flexor digitorum profundus muscle was too short to use for transfer. Conclusions. These results offer a suitable alternative to tendon transfer for restoring finger and wrist extension in cases of irreversible radial palsy. The second step would be clinical verification in appropriate cases.

The Flexor Pollicis Longus and its Relation to the Anterior and Posterior Interosseous Nerves

1998 ◽  
Vol 23 (2) ◽  
pp. 170-172 ◽  
Author(s):  
S. SHIRALI ◽  
M. HANSON ◽  
G. BRANOVACKI ◽  
M. GONZALEZ
Keyword(s):  
Median Nerve ◽  
Upper Extremities ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Anterior Interosseous Nerve ◽  
Flexor Digitorum

Sixty paired cadaver upper extremities were dissected to study the anatomy of the flexor pollicis longus in the forearm and its relation to the median and anterior interosseous nerves. An accessory head was noted in 33 (55%) of 60 specimens. The accessory head was noted to pass anterior to the anterior interosseous nerve in all specimens. The accessory head was noted to pass posterior to the median nerve in 57 specimens, and anterior to the nerve in three. Tendon or muscle anomalies were noted in eight specimens (13%), seven of which involved an anomalous attachment between the FPL and the flexor digitorum profundus of the index.

scholarly journals Anterior Interosseous Neuropathy in the Postpartum Period

1993 ◽  
Vol 20 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Lionel Carmant ◽  
Martin Veilleux
Keyword(s):  
Cervical Radiculopathy ◽  
Nerve Conduction Studies ◽  
Upper Extremities ◽  
Flexor Digitorum Profundus ◽  
Brachial Plexopathy ◽  
Flexor Pollicis Longus ◽  
Pronator Quadratus ◽  
Tunnel Syndrome ◽  
One Year ◽  
Flexor Digitorum

ABSTRACT:The anterior interosseous neuropathy is a rare focal neuropathy with typical clinical and electromyographic features. Most commonly reported etiologies include lesion of the median nerve following fracture of the radius and ulna, acute or repeated trauma or prolonged pressure on the forearm. In some cases, no predisposing factors can be elicited. Over a one-year period, two young women in their late twenties were evaluated for weakness of the flexor pollicis longus, flexor digitorum profundus of the 2nd and 3rd fingers, and pronator quadratus muscles that occurred within a month following parturition. Nerve conduction studies and concentric needle electrode examination of the upper extremities performed respectively 3 and 10 months after the onset of symptoms confirmed a severe anterior interosseous neuropathy and excluded more common conditions such as carpal tunnel syndrome, cervical radiculopathy or brachial plexopathy. The prognosis was unfavorable in both cases.

Brachioradialis Transfer for Digital Palsy

1990 ◽  
Vol 15 (3) ◽  
pp. 312-316
Author(s):  
J. M. FAILLA ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Pinch Grip ◽  
The Common ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Tendon Excursion

Although brachioradialis tendon transfer is thought to offer limited tendon excursion and finger motion, we have used it to restore active thumb and digital function in eight patients. Three had Volkmann’s contracture, one avulsion of forearm muscles and four had tetraplegia resulting in inability to perform activities of daily living and loss of pinch or grasp and extrinsic extension. The brachioradialis was transferred to the flexor pollicis longus, to the flexor digitorum profundus or to the common digital extensors. Except for one patient who had unremitting pain, all were pleased with their improved motion, pinch, grip, and independence. Function, however, remained abnormal in all but one.

LINBURG-COMSTOCK PHENOMENON FOLLOWING FOREARM LACERATION

Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 221-224 ◽  
Author(s):  
B. Lin ◽  
S. Sreedharan ◽  
Andrew Y. H. Chin
Keyword(s):  
Index Finger ◽  
Interphalangeal Joint ◽  
Penetrating Injury ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Right ◽  
Flexor Digitorum ◽  
Wide Awake

A 20-year-old man presented with an inability to flex the interphalangeal joint of the right thumb without simultaneous flexion of the distal interphalangeal joint of the index finger following a penetrating injury to the right forearm. With a clinical suspicion of intertendinous adhesions between the flexor pollicis longus and the flexor digitorum profundus to the index finger, surgical exploration under wide-awake anesthesia was performed. Intraoperatively, the intertendinous adhesions were identified and divided completely. Postoperatively, the patient achieved good, independent flexion of the interphalangeal joint of the thumb. This case demonstrates a clinical picture similar to that of Linburg-Comstock syndrome, which occurred following a forearm penetrating injury. We call this the Linburg-Comstock (LC) phenomenon.

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