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Constrictive paralysis of the posterior interosseous nerve without external compression
1Department of Orthopaedic Surgery, Nagoya University School of Medicine, Japan.
Journal of Hand Surgery (Edinburgh, Scotland)
|April 1, 1996
Summary
Idiopathic posterior interosseous nerve (PIN) constrictive neuropathy can cause elbow pain and paralysis. Surgical release of nerve constrictions led to motor function recovery in most patients, highlighting a treatable cause of nerve dysfunction.
Area of Science:
- Orthopedic Surgery
- Neurology
- Peripheral Nerve Disorders
Background:
- Posterior interosseous nerve (PIN) neuropathy typically results from external compression.
- Idiopathic cases without obvious external causes are less understood.
Observation:
- Four patients presented with severe elbow pain and subsequent PIN paralysis.
- Localized constrictions on the PIN were identified proximal to the arcade of Frohse.
- No external compressive etiology was evident in these cases.
Findings:
- Surgical intervention (epineurotomy +/- neurorrhaphy) was performed on the constricted PIN segments.
- Three out of four patients achieved complete motor function recovery within one year post-surgery.
- One patient required tendon transfer following nerve segment resection due to persistent deficits.
Implications:
- This study identifies intrinsic nerve constrictions as a cause of idiopathic PIN neuropathy.
- Early surgical decompression can restore motor function in affected individuals.
- Understanding these intrinsic causes is crucial for accurate diagnosis and effective treatment of PIN palsy.