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Distal posterior interosseous nerve syndrome.

D Carr, P Davis

    The Journal of Hand Surgery
    |November 1, 1985
    PubMed
    Summary

    Repetitive wrist movements can cause dorsal wrist pain due to distal posterior interosseous nerve syndrome. Surgical exploration revealed nerve fibrosis, offering a new diagnosis for wrist pain.

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    Area of Science:

    • Orthopedics
    • Neurology
    • Hand Surgery

    Background:

    • Dorsal wrist pain is a common complaint, often linked to repetitive motions.
    • Existing diagnoses include dorsal ganglia, scapholunate ligament degeneration, and dorsal wrist syndrome.

    Purpose of the Study:

    • To describe a distinct cause of dorsal wrist pain related to repetitive dorsiflexion.
    • To identify and characterize distal posterior interosseous nerve syndrome.

    Main Methods:

    • Case series of 13 patients with dorsal wrist pain.
    • Clinical examination, selective bupivacaine block of the posterior interosseous nerve.
    • Surgical exploration and histologic analysis of affected nerves.

    Main Results:

    • Six patients with persistent pain unresponsive to conservative treatment underwent surgery.
    • Surgical findings included enlarged, fibrotic posterior interosseous nerves.
    • Histology confirmed perineural fibrosis, significantly greater than in controls.

    Conclusions:

    • Distal posterior interosseous nerve syndrome is proposed as a new diagnosis for dorsal wrist pain.
    • Perineural fibrosis of the posterior interosseous nerve is the likely underlying pathology.
    • This syndrome is distinct from other common causes of dorsal wrist pain.

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