Article Text

Download PDFPDF
Posterior interosseous neuropathy: distinguishing from a proximal radial neuropathy
  1. Mary Clare McKenna1,
  2. Jack Woods2,
  3. Róisín Dolan2 and
  4. Seán Connolly1
  1. 1Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland
  2. 2Plastic and Reconstructive Surgery, St Vincent's University Hospital, Dublin, Ireland
  1. Correspondence to Dr Mary Clare McKenna; mary.mc-kenna.1{at}ucdconnect.ie

Abstract

The posterior interosseous nerve is the terminal motor branch of the radial nerve that innervates the extensor carpi ulnaris and the extensors of the thumb and fingers. We describe a case of a posterior interosseous neuropathy presenting with the typical ‘finger drop’ and partial ‘wrist drop’. We focus on the clinical signs that distinguish it from a more proximal radial neuropathy, clarified by nerve conduction studies and needle electromyography. Multimodal imaging of the forearm did not identify a compressive lesion. Persistent symptoms prompted surgical exploration 5 years after initial onset. It identified compression of the posterior interosseous nerve in the region of the arcade of Frohse and leash of Henry. The sites were decompressed and concurrent salvage secondary reconstructive tendon transfers were required in view of the severe axonal loss with minimal chance of functional reinnervation.

  • clinical neurophysiology
  • peripheral nerve disease
  • plastic and reconstructive surgery

Statistics from Altmetric.com

Footnotes

  • Contributors MCMcK was involved in study conception and design, data analysis and writing the manuscript. JW was involved in patient care, reviewing and approving the final manuscript. RD was involved in patient care, data analysis, and reviewing and approving the final manuscript. SC was involved in patient care, study conception and design, data acquisition and analysis, and reviewing and approving the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.