Pronator Teres Syndrome: Anterior Interosseous Nerve Compressive Neuropathy

2020 ◽  
pp. 209-215
Author(s):  
Konstantinos Anagnostakos ◽  
Nikolaos P. Zagoreos ◽  
Nickolaos A. Darlis
Keyword(s):  
Pronator Teres ◽  
Compressive Neuropathy ◽  
Anterior Interosseous Nerve

scholarly journals Two muscular variations in the elbow associated with the anterior interosseous nerve

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Bartłomiej Szewczyk ◽  
Nicol Zielinska ◽  
Dariusz Grzelecki ◽  
Michał Polguj
Keyword(s):  
Biceps Brachii ◽  
Clinical Importance ◽  
Ulnar Artery ◽  
Flexor Pollicis Longus ◽  
Main Band ◽  
Anatomical Dissection ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Male Cadaver ◽  
The Right

AbstractThe coexistence of different muscular-neurovascular variations is of significant clinical importance. A male cadaver, 76 years old at death, was subjected to routine anatomical dissection; the procedure was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The right forearm and hand were dissected using standard techniques according to a strictly specified protocol. The presence accessory head of the flexor pollicis longus may potentially compress the anterior interosseous nerve. The present case report describes a rare variant of the ulnar head of the pronator teres, characterized by two independent bands (i.e., two proximal attachments). The main band originates from the coronoid process and the second originates from the tendon of the biceps brachii. This type of attachment could potentially affect the compression of the ulnar artery running between the two bands. Additionally, the accessory head of the flexor pollicis longus was observed, which started on the medial epicondyle; its coexistence with a high division median nerve creates a potential pressure site on the anterior interesosseous nerve.

Transient Proximal Median Nerve Entrapment in a Tetraplegic Hand Cyclist Following a 24-Hour Endurance Race

2021 ◽  
Author(s):  
Søren Bruno Elmgreen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Unusual Case ◽  
Endurance Athlete ◽  
Nerve Entrapment ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Tunnel Syndrome ◽  
Anterior Interosseous Nerve Syndrome

ABSTRACT Median nerve entrapment is a frequent disorder encountered by all clinicians at some point of their career. Affecting the distal median nerve, entrapment occurs most frequently at the level of the wrist resulting in a carpal tunnel syndrome. Median nerve entrapment may also occur proximally giving rise to the much less frequent pronator teres syndrome and even less frequent anterior interosseous nerve syndrome, which owing to the paucity of cases may prove challenging to diagnose. An unusual case of anterior interosseous syndrome precipitated by extraordinary exertion in a tetraplegic endurance athlete is presented with ancillary dynamometric, electrodiagnostic, ultrasonographic, and biochemical findings.

Pronator Teres Branch Transfer to the Anterior Interosseous Nerve for Treating C8T1 Brachial Plexus Avulsion

Neurosurgery ◽  
2014 ◽  
Vol 75 (4) ◽  
pp. 375-379 ◽  
Author(s):  
Jianyun Yang ◽  
Xiaotian Jia ◽  
Cong Yu ◽  
YuDong Gu
Keyword(s):  
Range Of Motion ◽  
Lateral Condyle ◽  
Main Trunk ◽  
Medial Condyle ◽  
Pronator Teres ◽  
Finger Flexion ◽  
Active Range Of Motion ◽  
Anterior Interosseous Nerve ◽  
The Mean ◽  
Finger Flexor Muscles

Abstract BACKGROUND: The treatment of C8T1 avulsion is challenging for neurosurgeons. Various methods for the restoration of finger flexion are used. However, most of these methods have different disadvantages and cannot restore the full active range of motion of the fingers. OBJECTIVE: To determine the feasibility of the pronator teres branch transfer to the anterior interosseous nerve with anatomic study and to use this method in 1 case. METHODS: The upper limbs of 15 fresh cadavers were dissected to identify the main trunk of the median nerve, the pronator teres branch, and the anterior interosseous nerve. The mean number and length of the pronator teres branches were recorded. The anterior interosseous nerve was dissected atraumatically to the most proximal level where the fibers of the anterior interosseous nerve did not mingle with the fibers of the main trunk of the median, which was defined as the atraumatic level of the anterior interosseous nerve. A line joining the most protruding point of the medial condyle and lateral condyle of the humerus was used as a measurement landmark. Pronator teres branch transfer to the anterior interosseous nerve was performed in 1 patient with C8T1 avulsion. RESULTS: The mean number of the pronator teres branches was 2.37 ± 0.49. The mean length of the pronator teres branches was 9.64 ± 0.71 mm. The mean distance between the point where the pronator teres branches originated and the landmark line was 3.87 ± 0.34 mm. The mean distance between the atraumatic level of the anterior interosseous nerve and the landmark line was −5.46 ± 0.73 mm. Transfer of the pronator teres was used to innervate the anterior interosseous nerve in 1 patient with C8T1 avulsion. When assessed 14 months after the operation, a full active range of motion of the fingers had been restored, and the patient's finger flexor muscles had regained grade 4 power. CONCLUSION: The pronator teres can be transferred to the anterior interosseous nerve directly at the elbow level. This operation was performed successfully in 1 patient, who exhibited finger flexion recovery.

scholarly journals Gantzer muscles; a study on 50 cadaveric upper limbs

2015 ◽  
Vol 04 (04) ◽  
pp. 179-185
Author(s):  
Roshni Bajpe ◽  
Tarakeshwari R. ◽  
Shubha R.
Keyword(s):  
Median Nerve ◽  
Ulnar Artery ◽  
South Indian Population ◽  
Upper Limbs ◽  
Compressive Neuropathy ◽  
South Indian ◽  
Anterior Interosseous Nerve ◽  
The Right ◽  
Deep Flexors ◽  
Flexor Digitorum

Abstract Background : Gantzer muscle is the name given to the additional head of Flexor Digitorum Profudus (FDP) or Flexor Pollicis Longus (FPL). It connects the superficial flexors and deep flexors of forearm. It sometimes may be related to Anterior Interosseous Nerve (AIN) and Ulnar artery causing Compressive Neuropathy or Vascular symptoms. Aim: To assess incidence of Gantzer muscle in South Indian population, its morphology and clinical significance. Materials and methods: The study was carried out on 50 upper limbs dissected by first year M.B.B.S students. Results : Nine upper limbs showed the presence of Gantzer muscle, three belonged to the right and six belonged to the left. Observations : Additional heads were associated as follows: From FDP-2 and from FPL-7. Innervation was either from Median nerve, Anterior Interosseous nerve or Ulnar nerve. Superficially median nerve was related, deep relations were Ulnar artery and Anterior Interosseous nerve. In one case, Median nerve and artery were related superficially. Conclusion: Gantzer muscle is important clinically as a cause of vascular or nerve compression.

scholarly journals STRUTHERS’ LIGAMENT AND SUPRACONDYLAR HUMERAL PROCESS: AN ANATOMICAL STUDY AND CLINICAL IMPLICATIONS

2017 ◽  
Vol 25 (4) ◽  
pp. 137-142 ◽  
Author(s):  
Edie Benedito Caetano ◽  
João José Sabongi Neto ◽  
Luiz Angelo Vieira ◽  
Maurício Ferreira Caetano ◽  
José Eduardo de Bona ◽  
...  
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Case Series ◽  
Anatomical Study ◽  
Nerve Compression ◽  
Clinical Implications ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Compressive Neuropathy ◽  
Anatomy Laboratory

ABSTRACT Objective: The objective of this study was to determine the frequency and anatomical characteristics of Struthers’ ligament and the supracondylar humeral process and evaluate the clinical implications in compressive neuropathy of the median nerve . Method: We dissected 60 arms from 30 cadavers (26 males and 4 females): 15 were previously preserved in formalin and glycerin and 15 were dissected fresh in the Anatomy Laboratory for this paper. The relationships between Struthers’ ligament and the median nerve and brachial artery and veins were documented with drawings and photos . Results: The supracondylar humeral process was not found in any of the 60 dissected arms. Struthers’ ligament was identified in six arms (two bilateral); in all cases high insertion of the pronator teres muscle was observed . Conclusion: Struthers’ ligament is an aponeurotic structure that may or may not be associated with the supracondylar humeral process, and is an important potential site of median nerve compression in the lower third of the arm. Level of Evidence IV, Case Series.

An Anomaly of the Median Artery Associated with the Anterior Interosseous Nerve Syndrome

1992 ◽  
Vol 17 (5) ◽  
pp. 507-509 ◽  
Author(s):  
T. W. PROUDMAN ◽  
P. J. MENZ
Keyword(s):  
Flexor Digitorum Profundus ◽  
Vascular Compression ◽  
Pronator Quadratus ◽  
Pronator Teres ◽  
Longus Muscle ◽  
Anterior Interosseous Nerve ◽  
Median Artery ◽  
Anterior Interosseous Nerve Syndrome ◽  
Pronator Quadratus Muscle ◽  
Flexor Digitorum

The anterior interosseous nerve syndrome is characterized by paralysis of the flexor pollicis longus muscle, the flexor digitorum profundus muscle to the index and middle fingers, and the pronator quadratus muscle. The most common cause is entrapment of the anterior interosseous nerve near its origin from the median nerve by a variety of structures. Compression is most frequently caused by the deep head of the pronator teres muscle, or the fibrous arcade of the flexor digitorum superficialis muscle. Vascular compression has been reported infrequently. A patient with anterior interosseous nerve syndrome was found at operation to have the median artery passing through the anterior interosseous nerve just below the elbow. This artery has not previously been associated with the syndrome. A cadaver dissection confirmed the relationship.

Median Neuropathy—Pronator Teres Syndrome and Anterior Interosseous Neuropathy

2018 ◽  
Author(s):  
Russell A. Payne ◽  
Kimberly S. Harbaugh
Keyword(s):  
Nerve Palsy ◽  
Cervical Radiculopathy ◽  
Distal Phalanx ◽  
Neuralgic Amyotrophy ◽  
Pronator Teres ◽  
Pronator Syndrome ◽  
Anterior Interosseous Nerve ◽  
Tunnel Syndrome ◽  
Volar Forearm ◽  
Forearm Pain

Pronator teres syndrome results from median nerve compression or irritation at the elbow region. Patients typically note volar forearm pain and median sensory disturbance that includes the palm. Electrodiagnostic studies are helpful in excluding carpal tunnel syndrome and cervical radiculopathy, and findings may be normal in pronator syndrome. A lack of sensory findings and motor loss in flexion of the distal phalanx of the radial three digits suggests anterior interosseous nerve palsy, typically due to neuralgic amyotrophy. When conservative treatment fails, surgical release of all potential points of compression is successful in alleviating symptoms in the majority of patients with pronator syndrome.

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