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Updated: May 23, 2025

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Targeted Muscle Reinnervation Using the Anterior Interosseous Nerve for Symptomatic Wrist Level Neuromas.

Mitchell G Fagan1, Bradley H C Greene2, Joshua A Gillis1

  • 1Memorial University of Newfoundland, St. John's, Canada.

Hand (New York, N.Y.)
|May 22, 2025
PubMed
Summary

Targeted muscle reinnervation (TMR) using the anterior interosseous nerve (AIN) effectively treats wrist neuromas. This procedure resolved pain and improved function in four patients, with lasting benefits observed in long-term follow-up.

Keywords:
anatomydiagnosisforearmhandnervenerve injurypainspecialtysurgerytrauma

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Area of Science:

  • Neurosurgery
  • Regenerative Medicine
  • Peripheral Nerve Surgery

Background:

  • Iatrogenic and traumatic injuries can cause debilitating wrist neuromas.
  • Targeted muscle reinnervation (TMR) is a recognized treatment for symptomatic neuromas.
  • This study explores using the anterior interosseous nerve (AIN) as a recipient nerve for TMR.

Purpose of the Study:

  • To evaluate the efficacy of TMR using the AIN as a recipient nerve for treating wrist neuromas.
  • To assess outcomes for patients with lateral antebrachial cutaneous (LABC), palmar cutaneous (PCB), or radial sensory nerve (RSN) neuromas.

Main Methods:

  • Four patients with symptomatic LABC, PCB, or RSN neuromas underwent TMR.
  • The motor branch of the AIN to the pronator quadratus served as the recipient nerve.
  • Neuromas were transected, and end-to-end coaptation was performed between the donor nerve and the distal AIN.

Main Results:

  • All patients reported pain and symptom resolution at routine follow-up (2-10 months).
  • Long-term follow-up (25-49 months) showed sustained improvement, with two patients experiencing mild, recurrent hyperesthesia.
  • All patients returned to work, reporting improved function and reduced pain post-TMR.

Conclusions:

  • The distal AIN motor branch is a viable recipient nerve for TMR in managing wrist neuromas.
  • TMR utilizing the AIN demonstrates significant pain reduction and functional improvement.
  • Long-term outcomes support the use of AIN TMR for symptomatic wrist neuromas.