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Posterior interosseous nerve entrapments: review of the literature. Is the entrapment distal to the arcade of Frohse a really rare condition?

  • Review Article - Peripheral Nerves
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Abstract

Introduction

Spontaneous posterior interosseous nerve palsy is a rare condition. Entrapment is mostly at level of the arcade of Frohse, and a few cases of distal entrapment have been described.

Methods

A case of entrapment distal to the arcade of Frohse is described here. Cases of distal entrapment have been reviewed from the published literature in order to evaluate the frequency of atraumatic mechanical palsy.

Results

Seven cases of distal entrapment have been identified. Lesion is the cause of palsy in 58.7% of the cases and entrapment in 20.65%. The pathology is at the elbow in 33.7% of the cases, at the arcade of Frohse in 28.26%, and at the supinator canal in 10.33%. Entrapment is at the arcade of Frohse in 64.45%, proximal in 20%, and distal in 15.55%.

Conclusion

Posterior interosseous nerve distal entrapment is a rare condition; therefore, further investigation is needed when radiological images at the arcade of Frohse do not show any entrapment.

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Authors and Affiliations

  1. Department of Neurosurgery, Policlinico San Martino, University of Genoa, Largo Rosanna Benzi 10, 16143, Genoa, Italy

    Pasquale Anania, Pietro Fiaschi, Marco Ceraudo, Alberto Balestrino & Sergio Gennaro

  2. Department of Neurosurgery, Policlinico San Martino Hospital, University Hospital, Largo Rosanna Benzi 10, 16132, Genoa, Italy

    Pasquale Anania

  3. Department of Radiology, Policlinico San Martino, University of Genoa, Largo Rosanna Benzi 10, 16143, Genoa, Italy

    Federico Zaottini & Carlo Martinoli

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  1. Pasquale Anania
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  2. Pietro Fiaschi
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Correspondence to Pasquale Anania.

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Comments

The authors bring to our attention the fact that the posterior interosseous nerve can be entrapped in multiple locations. In the past a patient presenting with posterior interosseous syndrome would have an exploration of the posterior interosseous nerve extending from its origin to its course into the supraspinatus muscle. I believe that the distal entrapment of the nerve would not have been found by most surgeons. The authors very nicely demonstrate the value of ultrasound and MRI to localize the site of entrapment prior to the surgery. Unlike carpal tunnel syndrome, the locus of the entrapment of the posterior interosseous nerve will vary from patient to patient. The authors demonstrate an appropriate preoperative work-up for a patient presenting with PIN entrapment syndrome.

Allan Friedman

Durham, NC, USA

This article is part of the Topical Collection on Peripheral Nerves

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Anania, P., Fiaschi, P., Ceraudo, M. et al. Posterior interosseous nerve entrapments: review of the literature. Is the entrapment distal to the arcade of Frohse a really rare condition?. Acta Neurochir 160, 1857–1864 (2018). https://doi.org/10.1007/s00701-018-3615-8

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