Persistent anterior interosseous nerve palsy following forearm crutch use

Macneal, Peter; Crome, Christopher Robert; McNally, Scarlett

doi:10.1136/bcr-2016-218240

Cited by 5 publications

(4 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…58,63 Improper crutch fitting was identified as a risk factor in only one case. 64 Injuries Where Crutch Type Was Not Specified Overall, 501 injuries were reported following the use of an unspecified crutch. Ninety-eight percent were musculoskeletal.…”

Section: Neurological Forearm Crutch-related Injuriesmentioning

confidence: 99%

Injuries Associated with Crutch Use: A Narrative Review

Manocha

MacGillivray

Eshraghi

et al. 2020

PM&R

View full text Add to dashboard Cite

Crutches are commonly prescribed in physiatric settings to help offload the lower extremities. Crutch use, however, results in abnormal and repetitive weight-bearing through the upper extremities that may result in secondary injury. This narrative review investigates injury types and risk factors associated with crutch use in order to guide healthcare providers on injury prevention strategies. Medline, EMBASE, CINAHL, and the Cochrane Library were systematically reviewed for publications between 1950 and 2018 on neurological, musculoskeletal, or vascular complications associated with crutch use. Titles and abstracts (n = 2395) were screened by two authors. Sixty studies were eligible. Articles were reviewed for level of evidence, crutch type, participant characteristics, and injury characteristics. There were 42 axillary crutch studies, 12 forearm crutch studies, and 6 studies that did not specify crutch type. These studies incorporated 622 individuals, and most were case series or case reports (n = 54). Axillary crutch use was most commonly associated with axillobrachial arterial complications due to pressure from the axillary bar (n = 34). Forearm crutch use was most commonly associated with compressive neuropathies due to pressure from the forearm cuff (n = 6). Improper crutch fitting and/or use were identified as contributing factors to injury in 22 cases. Duration of crutch use and medical comorbidities also influenced the types of injuries seen. There are rare but potentially serious complications associated with crutch use. When prescribing crutches, clinicians should ensure they are properly fit, engage in appropriate gait training, be aware of common crutch-related injuries, and consider potential patient-specific injury risk factors in order to minimize injury risk.

show abstract

Section: Neurological Forearm Crutch-related Injuriesmentioning

confidence: 99%

Injuries Associated with Crutch Use: A Narrative Review

Manocha

MacGillivray

Eshraghi

et al. 2020

PM&R

View full text Add to dashboard Cite

show abstract

“…Chronic axillary crutch users are at an increased risk of developing neurovascular complications [13]. Muscle weakness and sensory disturbances may implicate nerve injury, while axillary and or brachial artery stenoses and aneurysms can lead to rupture or secondary thromboembolic episodes in the upper extremities [1][2][3][4][5][6][7][8][9][10][11]. For crutch users, supporting weight on the upper support of the crutches is thus not recommended because it can lead to neurovascular damage [13].…”

Section: Discussionmentioning

confidence: 99%

“…Another report by Macneal et al, described two patients who developed persistent anterior interosseous nerve palsy after the use of forearm crutches [3]. These cases were managed conservatively, but little clinical improvement was seen for over four months.…”

Section: Nerve Injurymentioning

confidence: 99%

Crutch Walking-Induced Neurovascular Complications

2018

OJSC

View full text Add to dashboard Cite

Background/Purpose: The use of crutches is frequently necessary in orthopedic patients. However, improper use of crutches may lead to neurovascular complications. Material and Methods: We reviewed studies written in English that were published between January, 1980 and the end of June, 2018, regarding crutch walking-induced complications. Our survey revealed three case reports that described nerve complications and eight that described vascular complications following crutch usage. Results: Muscle weakness and sensory disturbances likely occurred due to nerve injury, while axillary and or brachial artery stenoses and aneurysms lead to rupture or thromboembolism in the upper extremities. Nerve injuries developed in patients who had used one or multiple crutches for only a transient period, and in these cases, crutches were most often used due to leg fractures. Most vascular complications occurred in those who had used crutches for over fifty years, and the main reasons for crutch usage in these cases were poliomyelitis and lower limb amputation. Discussion: The proper use of crutches is essential. Users should be aware of the possibility of crutch-induced neurovascular injury and they should be followed with serial imaging even if no ischemic episodes occur in the upper extremity.

show abstract

“…23 As discussed above, these cases are not considered true AINS due to originating from an external compressive etiology, and symptoms have consistently been shown to resolve once the external compression is eliminated. [24][25][26][27][28] CLINICAL PRESENTATION/DIAGNOSIS AINS often occurs spontaneously and is often found to follow an inciting event such as trauma, pregnancy, or stress. 14,29 Diabetes, human immunodeficiency virus, and nutritional deficiencies have been associated with the development of AINS.…”

Section: Introductionmentioning

confidence: 99%

Anterior Interosseous Nerve Syndrome

Russo

Rando

et al. 2022

Orthopedic Reviews

View full text Add to dashboard Cite

Anterior interosseous nerve syndrome (AINS) is a rare form of peripheral neuropathy which involves disruption of the anterior interosseous nerve. The pathophysiology of AINS remains unclear. AINS typically initially presents with forearm pain and may gradually progress to palsy of the deep muscles of the anterior forearm. Diagnosis of AINS requires thorough patient history and physical exam. EMG is the preferred diagnostic study and classically reveals abnormal activity and prolonged latency periods within the evoked action potentials of the FPL and PQ. Due to the self-limiting nature of AINS, there is general agreement that conservative and symptomatic management should be explored for up to 6 months as first line therapy, which usually includes analgesics and nonsteroidal anti-inflammatory drugs, contracture prevention, hand therapy, and hand splinting. Surgical options such as internal neurolysis and minimally invasive endoscopic decompression may be explored if functional recovery from conservative management is limited.

show abstract

Persistent anterior interosseous nerve palsy following forearm crutch use

Cited by 5 publications

References 23 publications

Injuries Associated with Crutch Use: A Narrative Review

Injuries Associated with Crutch Use: A Narrative Review

Crutch Walking-Induced Neurovascular Complications

Anterior Interosseous Nerve Syndrome

Contact Info

Product

Resources

About