The Anterior Interosseous Nerve Syndrome: Clinical Investigation of Surgically Treated 7 Cases

Kim,  Hyoung Min; Jeong,  Changhoon; Lee,  Sang Uk; Roh,  Youn Tae; Park,  Il Jung

doi:2009.18.2.67

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Arch Hand Microsurg > Volume 18(2); 2009 > Article

Case Report

Journal of the Korean Society for Surgery of the Hand 2009;18(2):67-74.
Published online November 30, 2009.
DOI: https://doi.org/10.12790/jkssh.2009.18.2.67

The Anterior Interosseous Nerve Syndrome: Clinical Investigation of Surgically Treated 7 Cases

Hyoung-Min Kim, M.D., Changhoon Jeong, M.D., Sang-Uk Lee, M.D., Youn-Tae Roh, M.D., Il-Jung Park, M.D.

Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea. jikocmc@naver.com

전방골간신경 증후군: 수술적으로 치료한 7예에 대한 임상적 고찰

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Abstract

Purpose: The etiology and treatment strategy of the anterior interosseous nerve (AIN) syndrome are still controversial. Seven patients with the AIN syndrome who were treated by surgical exploration and neurolysis were reviewed at a mean of 35.9 months follow up period.
Materials & Methods: There were six men and one woman. The mean age was 37.3 years, ranging from 26 to 59. No patient was related to trauma and associated neurological lesion. Surgical exploration was performed at 7.7 months after onset of paralysis.
Results: All except one patients experienced pain around the elbow region before the onset of the palsy. On 7 patients, only the flexor pollicis longus was paralysed in 1, only the index flexor digitorum profundus in 2, and none had paralysis of the middle. The most common compression structures were fibrous bands within flexor digitorum sublimis arcade. However there was no demonstrable abnormality in three. Recovery was complete in all cases within 12 months after surgery.
Conclusion: We recommended surgical exploration and neurolysis in patients who have shown no improvement after 6 months of conservative treatment. And careful preoperative examination is essential to avoid misdiagnosis and inappropriate surgery, especially in incomplete AIN syndrome.

Key Words: Anterior interosseous nerve syndrome, Flexor pollicis longus, Flexor digitorum profundus, Pronator quadratus, Surgical exploration

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