Potential for Posterior Interosseus Nerve Entrapment Suggests Exploration Is a Viable Option Following Distal Biceps...

Area of Science:

• Orthopedic Surgery
• Nerve Injury
• Reconstructive Surgery

Background:

• Distal biceps repair is a common orthopedic procedure.
• Complications can arise, including nerve injury.
• Posterior interosseus nerve (PIN) palsy is a potential, though rare, complication.

Purpose of the Study:

• To report a case of posterior interosseus nerve (PIN) palsy following distal biceps repair.
• To highlight the importance of precise cortical button placement.
• To discuss management strategies for PIN palsy after this procedure.

Main Methods:

• A case study of a 34-year-old male patient is presented.
• The patient underwent surgical exploration for suspected PIN palsy.
• The entrapped nerve was identified and the causative device removed.

Main Results:

• The patient developed finger extensor weakness, indicative of PIN palsy, postoperatively.
• Surgical exploration revealed direct entrapment of the PIN by the cortical button.
• Removal of the cortical button led to resolution of the palsy.

Conclusions:

• Precise placement of the cortical button during distal biceps repair is critical.
• Optimal placement involves centering the button on the bicipital tuberosity, aligned with the radial long axis.
• Surgical intervention, including potential Endobutton removal, is indicated for postoperative PIN palsy.