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Neglected posterior interosseous nerve injury
Dong Yun Lee1, Jung Soo Yoon1, SooA Lim1
1Department of Plastic and Reconstructive Surgery, DongGuk University School of Medicine, Seoul, South Korea.
Trauma Case Reports
|April 4, 2024
Summary
A rare posterior interosseous nerve (PIN) injury, caused by a penetrating forearm wound, led to finger extension loss. Delayed nerve repair with a cable graft successfully restored function.
Area of Science:
- Orthopedic Surgery
- Neurology
- Hand Surgery
Background:
- Posterior interosseous nerve (PIN) injuries are infrequent due to the nerve's deep anatomical position.
- Penetrating trauma to the forearm presents a diagnostic challenge for PIN injury.
Observation:
- A 49-year-old male presented with loss of extension in the thumb, index, and small fingers, and thumb abduction weakness after a penetrating forearm injury.
- Initial emergency surgery for the forearm wound did not identify the extent of the nerve damage.
Findings:
- Delayed examination revealed significant finger extension deficits (20° thumb/index, 30° small finger) and a neuroma at the proximal PIN stump.
- A double-strip cable graft was utilized for delayed nerve repair.
Implications:
- Highlights the importance of thorough preoperative physical examination for neurovascular deficits in forearm penetrating injuries.
- Emphasizes the necessity of careful surgical exploration and timely repair of posterior interosseous nerve injuries, even in emergency settings.
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