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Forearm Lipoma Causing PIN Compression: Literature Review and Meta-Analysis of Predictors for Motor Recovery
Christopher Cheng1, Ayesha Punjabi2, Sven Gunther2
1Case Western Reserve University/University Hospitals, Cleveland, OH, USA.
Hand (New York, N.Y.)
|June 3, 2022
Summary
Most patients with posterior interosseous nerve (PIN) compression from lipomas achieve full motor recovery after surgical excision. Consider tendon transfers for symptoms lasting over 18 months.
Area of Science:
- Orthopedic Surgery
- Nerve Compression Syndromes
- Musculoskeletal Tumors
Background:
- Lipomas are an uncommon cause of posterior interosseous nerve (PIN) compression.
- Predictors for motor recovery following PIN compression by lipomas have not been systematically reviewed.
- This study aimed to identify patient and lipoma characteristics influencing motor recovery after surgical intervention.
Approach:
- A systematic review of articles detailing patients with forearm lipomas causing PIN compression and motor weakness.
- Data extracted included patient demographics, lipoma size and duration of symptoms, surgical procedures, and motor recovery outcomes.
- Article quality was assessed using the Methodological Index for Non-Randomized Studies criteria.
Key Points:
- Thirty articles involving 34 patients were analyzed, with an average age of 58.2 years and average lipoma size of 5.7 cm.
- Complete motor recovery was observed in 73.5% of patients at an average of 9.7 months post-excision.
- Neither patient age, lipoma size, nor symptom duration were significant predictors of motor recovery, though symptom duration under 18 months showed a positive trend.
Conclusions:
- Surgical excision of lipomas causing PIN compression typically results in substantial motor recovery.
- Tendon transfers may be beneficial for patients with symptoms exceeding 18 months.
- Further research with larger sample sizes is needed to identify specific risk factors and optimize treatment strategies for the minority of patients requiring additional interventions.
