Summary
Lesions at the volar aspect of the forearm may lead to isolated paralysis of the anterior interosseous nerve, which is a purely motor branch of the median nerve. The same syndrome may result from circumscribed damage at the level of the upper arm. Two patients are reported with the typical anterior interosseous nerve syndrome following supracondylar lesions of the median nerve and the literature is reviewed. In most cases this syndrome is a complication of supracondylar fractures of the humerus in children. A simple clinical test for the diagnosis, the pinch test, and the typical electromyographic findings are described. Whereas electroneurography has been considered to provide little help in diagnosis, a significantly lower nerve conduction velocity was found in the median nerve between the medial intermuscular spatium and the cubital fossa compared to the normal arm, and a prolonged response latency of the pronator quadratus of the injured arm following stimulation of the median nerve in the intermuscular medial spatium and the cubital fossa.
Zusammenfassung
Das Interosseus-anterior-Syndrom ist meist verursacht durch eine Läsion dieses Astes des N. medianus im Bereich der volaren Seite des proximalen Unterarms. Weniger bekannt ist, daß das gleiche Syndrom auch von umschriebenen Läsionen im Verlauf des N. medianus oberhalb der Fossa cubiti zustande kommt. Die Literatur über das Auftreten dieses Syndroms bei supracondylären Läsionen, insbesondere bei supracondylären Frakturen des Humerus im Kindesalter, ist dargestellt. Ein einfacher klinischer Test für die Diagnose eines Interosseus-anterior-Syndroms, der Ring-Test, wird erwähnt. Typische elektromyographische Befunde werden demonstriert. Eine Methode, bei der die proximale Latenz des N. medianus zum M. abductor digiti quinti und zum M. pronator quadratus im Seitenvergleich untersucht wird, wird vorgestellt.
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References
Fahey JJ (1960) Fractures of the elbow in children. Instructional course lectures. The American Academy of Orthopedic Surgeons. XVII:13–46
Farber J, Bryan RS (1968) The anterior interosseous nerve syndrome. J Bone Joint Surg [Am] 50:521–523
Lake PA (1974) Anterior interosseous nerve syndrome. J Neurosurg 41:306–309
Lipscomb PR, Burleson RJ (1955) Vascular and neural complications in supracondylar fractures of the humerus in children. J Bone Joint Surg [Am] 37:487–492
Mumenthaler M, Schliack H (1982) Läsionen peripherer Nerven. Thieme, Stuttgart New York
O'Brien MD, Upton ARM (1972) Anterior interosseous nerve syndrome — a case report with neurophysiological investigation. J Neurol Neurosurg Psychiatry 35:531–536
Spinner M (1970) The anterior interosseous nerve syndrome. J Bone Joint Surg [Am] 52:84–94
Spinner M, Schreiber SN (1969) Anterior interosseous-nerve paralysis as a complication of supracondylar fractures of the humerus in children. J Bone Joint Surg [Am] 51:1584–1590
Spitzer AG, Paterson DC (1973) Acute nerve involvement in supracondylar fractures of the humerus in children. J Bone Joint Surg [Br] 55:227
Sunderland S (1945) The innervation of the flexor digitorum profundus and the lumbrical muscles. Anat Rec 93:317–321
Sunderland S (1945) The intraneural topography of the radial, median and ulnar nerves. Brain 68:243–299
Sunderland S (1978) Nerves and nerve injuries. Churchill Livingstone, Edinburgh London New York
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Meya, U., Hacke, W. Anterior interosseous nerve syndrome following supracondylar lesions of the median nerve: clinical findings and electrophysiological investigations. J Neurol 229, 91–96 (1983). https://doi.org/10.1007/BF00313447
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DOI: https://doi.org/10.1007/BF00313447