Anterior Interosseous Syndrome
- Description / Cause
- Anterior interosseous nerve entrapment between the two heads of the pronator heres
- Spontaneous or insidious onset
- Prevalence / Risk factors
- Common case study range of 30-65
- Rare
- 1% of all compressive neuropathies of the upper extremity
- Trauma
- External compression
- Signs / Symptoms
- Pain
- Sudden severe in forearm
- Resolves in hours
- Dull ache in forearm
- Weakness
- No sensory loss
- Objective / Special Test
- MMT
- Weakness in flexor pollicis longus, pronator quadratus, and lateral half of flexor digitorum profundus
- Pain
- Resisted IP thumb flexion
- Resisted distal IP flexion of index finger
- Pinch grip test
- Treatment / Interventions
- Early conservative care
- Immobilization
- NSAIDs
- Physical therapy
- Electrical stimulation of motor end plates of the involved muscles
- PROM
- IP joints of thumb, index, and long fingers
- Endoscopic decompression surgery
- Considered after 3 months of conservative care
- An electrophysiological exam before surgery is obligatory
- Differential diagnosis
- Flexor pollicis longus
References
- Damert H, Hoffmann R, Kraus A, Stowell R, Lubahn J. Surgical technique: Minimally Invasive Endoscopic Decompression for Anterior Interosseous Nerve Syndrome: Technical Notes. Journal Of Hand Surgery [serial online]. October 1, 2013;38:2016-2024. Available from: ScienceDirect, Ipswich, MA. Accessed June 30, 2015.
- Robertson E, Reimche, D. Differential Diagnosis for Various Neuropathies at the Elbow. Accessed June 30, 2015.
Acknowledgements:
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015