scholarly journals Unique case of anterior interosseous nerve injury following distal volar radial plating: A case report

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Gur A. S. Sidhu ◽  
Jamie Hind ◽  
Amr Abouelela ◽  
Neil Ashwood ◽  
Christos Kitsis
Keyword(s):  
Nerve Injury ◽  
Index Finger ◽  
Treatment Options ◽  
Normal Function ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Nerve Entrapments ◽  
Anterior Interosseous Nerve ◽  
Joint Flexion ◽  
Flexor Digitorum

Trauma itself, surgery, nerve entrapments, amyotrophic neuropathy, or neuritis may result in anterior interosseous nerve (AIN) palsy. A 76-year-old woman who was operated for distal end radius fracture with plating was referred back referred back to the clinic by her general practitioner with complaints of inability to flex the interphalangeal joint of the thumb and index finger approximately 3 years after the index surgery. The proximal interphalangeal joint flexion (flexor digitorum superficialis) of the index finger was intact and the pinch power was reduced. She had normal function of her other forearm and hand muscles. Ultrasonography and nerve conduction velocity (NCV) studies were done to investigate further to rule out either tendon flexor pollicis longus (FPL) or nerve injury (AIN). NCV studies reported subacute denervation within the FPL. The patient recovered to near normal without any surgical intervention in 18 months. Literature reported various treatment options in the form of conservative as well as surgical depending on the cause and evidence of recovery.

Comparative study on the effectiveness of corticosteroid injections between trigger fingers with and without proximal interphalangeal joint flexion contracture

2015 ◽  
Vol 41 (2) ◽  
pp. 198-203 ◽  
Author(s):  
R. Shinomiya ◽  
T. Sunagawa ◽  
Y. Nakashima ◽  
Y. Kawanishi ◽  
T. Masuda ◽  
...  
Keyword(s):  
Corticosteroid Injection ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contracture ◽  
Flexor Digitorum Superficialis ◽  
Joint Flexion ◽  
Hypoechoic Lesion ◽  
Flexor Digitorum ◽  
A1 Pulley

Trigger fingers with proximal interphalangeal joint flexion contracture are suggested to have a poorer response to corticosteroid injection than those without contracture, though this has not been proven scientifically. We compared the clinical response to corticosteroid injection between trigger fingers with and without proximal interphalangeal joint contracture, and investigated the influence of the injection on the A1 pulley and flexor digitorum tendons using ultrasonography. One month after injection, pain was significantly reduced in the no contracture group, and 56% of trigger fingers with proximal interphalangeal joint contracture resolved. Before injection, relative thickening of the A1 pulley and flexor digitorum tendons, and a partial hypoechoic lesion of the flexor digitorum superficialis tendon were observed in the contracture group. One month after injection, the thickening of the tendons and the A1 pulley was reduced, but the partial hypoechoic lesion was still observed in significant numbers. We have demonstrated that the presence of a proximal interphalangeal joint contracture was associated with a reduced clinical response to corticosteroid injection, and we suggest that the pathologic change in the flexor digitorum superficialis tendon, represented by the partial hypoechoic lesion, contributed to corticosteroid injection resistance. Level of evidence: IV

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

LINBURG-COMSTOCK PHENOMENON FOLLOWING FOREARM LACERATION

Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 221-224 ◽  
Author(s):  
B. Lin ◽  
S. Sreedharan ◽  
Andrew Y. H. Chin
Keyword(s):  
Index Finger ◽  
Interphalangeal Joint ◽  
Penetrating Injury ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Right ◽  
Flexor Digitorum ◽  
Wide Awake

A 20-year-old man presented with an inability to flex the interphalangeal joint of the right thumb without simultaneous flexion of the distal interphalangeal joint of the index finger following a penetrating injury to the right forearm. With a clinical suspicion of intertendinous adhesions between the flexor pollicis longus and the flexor digitorum profundus to the index finger, surgical exploration under wide-awake anesthesia was performed. Intraoperatively, the intertendinous adhesions were identified and divided completely. Postoperatively, the patient achieved good, independent flexion of the interphalangeal joint of the thumb. This case demonstrates a clinical picture similar to that of Linburg-Comstock syndrome, which occurred following a forearm penetrating injury. We call this the Linburg-Comstock (LC) phenomenon.

Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis

1999 ◽  
Vol 90 (6) ◽  
pp. 1053-1056 ◽  
Author(s):  
Alexander Joist ◽  
Uwe Joosten ◽  
Dirk Wetterkamp ◽  
Michael Neuber ◽  
Axel Probst ◽  
...  
Keyword(s):  
Index Finger ◽  
Interphalangeal Joint ◽  
Nerve Compression ◽  
Flexor Digitorum Profundus ◽  
Pronator Quadratus ◽  
Motor Branch ◽  
Content Type ◽  
Anterior Interosseous Nerve ◽  
Anterior Interosseous Nerve Syndrome ◽  
Fine Print

Object. The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss.Methods. The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children. They have added a new case identified in a 7-year-old boy in whom a diagnosis was made from the clinical findings and whose treatment and outcome are analyzed. The ages of patients reported in the literature ranged from 4 to 10 years. Ten patients (29%) were treated with closed reduction and application of a cast, whereas 25 patients (71%) were treated with open reduction and fixation of the fracture.Conclusions. All patients regained full flexion and strength after 4 to 17 weeks. The fractures that were surgically treated showed no entrapment of the anterior interosseous nerve.

scholarly journals Infiltration of synovitis into the flexor tendon: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093618
Author(s):  
Qianjun Jin ◽  
Haiying Zhou ◽  
Hui Lu
Keyword(s):  
Flexor Tendon ◽  
Surgical Excision ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexion Angle ◽  
Flexor Digitorum Profundus ◽  
Normal Tendon ◽  
Active Flexion ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

Synovitis is a type of aseptic inflammation that occurs within joints or surrounding tendons. No previous reports have described a hypertrophic synovium eroding the tendon sheath and manifesting as synovitis within the flexor tendon. We herein report a case involving a 10-year-old girl who presented to our hospital with a 1-month history of a swollen mass and progressive inability to completely flex her left index finger. The active flexion angle of the proximal interphalangeal joint was limited to 85°. A longitudinal incision of the flexor digitorum profundus tendon was surgically performed. The synovium inside and outside the flexor digitorum profundus tendon was completely removed. After the surgical excision, normal tendon gliding returned without recurrence by the 1-year follow-up. The active flexion angle of the proximal interphalangeal joint improved to 100°. To the best of our knowledge, this is the first case of synovitis affecting the flexor tendon and leading to limited flexion of a finger. The manifestation of a double ring sign on magnetic resonance imaging is quite characteristic. Early diagnosis and monitoring of the hyperproliferation and invasiveness of the synovial tissue are required. Surgical excision can be a simple and effective tool when necessary.

Immediate Free Vascularized Joint Transfer from Second Toe to Index Finger Proximal Interphalangeal Joint: A Case Report

1985 ◽  
Vol 10 (1) ◽  
pp. 85-89 ◽  
Author(s):  
T. M. TSAI ◽  
R. SINGER ◽  
E. ELLIOTT ◽  
H. KLEIN
Keyword(s):  
Index Finger ◽  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Severe Injuries ◽  
Immediate Reconstruction ◽  
Joint Reconstruction ◽  
Results Of Treatment ◽  
Second Toe

The results of treatment of severe injuries to the proximal interphalangeal joint are unsatisfactory. The methods of joint reconstruction are discussed, including fusion, implant arthroplasty, perichondrial grafting and vascularized joint transfer. A patient is presented with a severe crush injury to the dorsum of the index finger with loss of skin and extensor tendon and proximal interphalangeal joint disruption. Immediate reconstruction of the finger is described using a composite free flap of skin, extensor tendon and proximal interphalangeal joint from the second toe. Follow-up at two years is described, demonstrating proximal interphalangeal motion and finger function.

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