Acta Ortopédica Mexicana

Domínguez-Gasca LG, Magaña-Reyes J, Álvarez-Rodríguez M, Domínguez-Carrillo LG
Injury of the anterior branch of the posterior interosseous nerve
Acta Ortop Mex 2019; 33 (2)

Language: Español
References:
Page: 123-126
PDF: 115.98 Kb.

[Fulltext - PDF]

ABSTRACT

Introduction: Posterior interosseous nerve syndrome, a branch of the radial nerve at the level of the forearm, is characterized by the motor function loss of some or all of the muscles innervated distally. Clinical case: A 26-year-old male with a history of proximal radius fracture associated to radial nerve injury, treated with osteosynthesis 7 years earlier, with full recovery, who currently presented intense pain 4 cm distal to the radial head, accompanied by paralysis of Extensor pollicis longus, Extesnor pollicis brevis and Abductor pollicis longus, with paresis of the Extensor indicis propius, in which a diagnosis of entrapment syndrome of the anterior descending branch of the posterior interosseous nerve (SNIP) was performed. Discussion: The conservative management of SNIP is indicated during the first 8-12 weeks, if no improvement is found, the indication for surgical exploration is indicated, and the removal of osteosynthesis material is controversial.


Key words: Posterior interosseous nerve, paralysis, complication, surgery, fracture.


REFERENCES

  1. Moraes MA, Gonçalves RG, Santos JB, Belloti JC, Faloppa F, Moraes VY. Diagnosis and treatment of posterior interosseous nerve entrapment: systematic review. Acta Ortop Bras. 2017; 25(1): 52-4.

  2. Berton C, Wavreille G, Lecomte F, Miletic B, Kim HJ, Fontaine C. The supinator muscle: anatomical bases for deep branch of the radial nerve entrapment. Surg Radiol Anat. 2013; 35(3): 217-24.

  3. Vergara-Amador E, Ramírez A. Anatomic study of the extensor carpi radialis brevis in its relation with the motor branch of the radial nerve. Orthop Traumatol Surg Res. 2015; 101(8): 909-12.

  4. Gelberman RH, Eaton R, Urbaniak JR. Peripheral nerve compression. J Bone Joint Surg. 1993; 75(12): 1854-78.

  5. Links AC, Graunke KS, Wahl C, Green JR 3rd, Matsen FA 3rd. Pronation can increase the pressure on the posterior interosseous nerve under the arcade of Frohse: a possible mechanism of palsy after two-incision repair for distal biceps rupture--clinical experience and a cadaveric investigation. J Shoulder Elbow Surg. 2009; 18(1): 64-8.

  6. Hirachi K, Kato H, Minami A, Kasashima T, Kaneda K. Clinical features and management of traumatic posterior interosseous nerve palsy. J Hand Surg. 1998; 23(3): 413-6.

  7. Choi SJ, Ahn JH, Ryu DS, Kang CH, Jung SM, Park MS, et al. Ultrasonography for nerve compression syndromes of the upper extremity. Ultrasonography. 2015; 34(4): 275-91.

  8. Albuquerque BJ, Coimbra NJ, Chagas NF. Posterior interosseous nerve compression syndrome: imaging findings highlights. Am J Med Case Rep. 2015; 3(12): 415-8.

  9. Mansuripur PK, Deren ME, Kamal R. Nerve compression syndromes of the upper extremity: diagnosis, treatment, and rehabilitation. R I Med J. 2013; 96(5): 37-9.

  10. Vos D, Hanson B, Verhofstad M. Implant removal of osteosynthesis: the Dutch practice. Results of a survey. J Trauma Manag Outcomes. 2012; 6(1): 6. doi: 10.1186/1752-2897-6-6.

  11. Azar JM, Beaty JH, Canale ST. Peripheral nerve injuries. Campbell’s operative orthopaedics. 13th ed. Philadelphia: Elsevier; 2017, 3162-225.

  12. Leclère FM, Bignion D, Franz T, Mathys L, Vögelin E. Endoscopically assisted nerve decompression of rare nerve compression syndromes at the upper extremity. Arch Orthop Trauma Surg. 2013; 133: 575-82.