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Isolated complete denervation of the flexor pollicis longus
1Department of PM&R, University of Missouri-Columbia School of Medicine 65212.
Archives of Physical Medicine and Rehabilitation
|May 1, 1990
Summary
A gunshot wound led to isolated paralysis of the flexor pollicis longus (FPL) muscle. Electromyography confirmed complete FPL denervation, a previously unreported finding.
Area of Science:
- Neurology
- Orthopedic Surgery
- Anatomy
Background:
- The flexor pollicis longus (FPL) is crucial for thumb flexion.
- Isolated denervation of the FPL is not well-documented in medical literature.
Observation:
- A 26-year-old male presented with paralysis of the left FPL after a gunshot wound to the index finger base.
- Surgical exploration of the radial digital artery and nerve was performed under axillary block anesthesia.
- Motor function of other digits and forearm pronation remained unaffected.
Findings:
- Electromyography (EMG) demonstrated complete, isolated denervation of the FPL.
- This indicates a lesion affecting the anterior interosseous nerve branches supplying the FPL.
- Possible causes include direct injury from catheter placement or neuralgic amyotrophy.
Implications:
- This case highlights a rare presentation of FPL paralysis.
- It underscores the importance of precise anatomical knowledge of the anterior interosseous nerve.
- Further investigation into iatrogenic or idiopathic causes of isolated FPL denervation is warranted.