Anterior interosseous nerve compression syndrome: Is there a role for endoscopy?
Background Anterior interosseous nerve syndrome is characterized by paralysis of the flexor digitorum profundus, the flexor pollicis longus and the pronator quadratus muscles without sensory loss. Extended exploration of the anterior interosseous nerve is the surgical treatment of choice. The presen...
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Published in | Acta neurochirurgica Vol. 153; no. 11; pp. 2225 - 2229 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Vienna
Springer Vienna
01.11.2011
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Summary: | Background
Anterior interosseous nerve syndrome is characterized by paralysis of the flexor digitorum profundus, the flexor pollicis longus and the pronator quadratus muscles without sensory loss. Extended exploration of the anterior interosseous nerve is the surgical treatment of choice. The present study evaluates the feasibility of an endoscopic approach for nerve decompression.
Methods
Preparation of the anterior interosseous nerve was performed in ten human cadaver arms. Subsequently, one female patient suffering from anterior interosseous nerve syndrome was endoscopically operated on.
Findings
A skin incision of 3–4 cm in the proximal direction was made at the forearm, and the median nerve was visualized between the pronator teres muscle and the flexor digitorum superficialis. Subsequently, the anterior interosseus nerve branch was identified, followed distally and decompressed under endoscopic view. The procedure could be accomplished in all cases under endoscopic view. Due to the very steep surgical angle, a branch of the anterior interosseus nerve was injured in one cadaver case. In all other cases, no adverse effects were observed. In the clinical case, the anterior interosseus nerve was endoscopically identified and decompressed, but a skin incision of 5 cm was required.
Conclusions
The results demonstrate that an endoscopic decompression of the anterior interosseus nerve is possible. Several difficulties occurred: Due to the depth of the surgical approach, especially in case of bulky muscles and very small skin incisions, the view is limited, harboring a higher risk of nerve injury. With more experience and specially designed endoscopes, application of this technique in anterior interosseus nerve compression syndrome might become more feasible. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Technical Report-2 content type line 23 ObjectType-Case Study-4 ObjectType-Feature-5 ObjectType-Report-3 ObjectType-Article-2 ObjectType-Feature-1 |
ISSN: | 0001-6268 0942-0940 |
DOI: | 10.1007/s00701-011-1091-5 |