Pronator Syndrome and Anterior Interosseous Nerve Syndrome

Persistent anterior interosseous nerve palsy following forearm crutch use

“…It is also important to distinguish AIN palsy from tendon rupture, for example, of the FPL. Passively extending the wrist fully and observing for flexion of the distal interphalageal joints of the fingers and interphalangeal joint of the thumb will demonstrate intact tendons 3. In the current case, these diagnostic tests were not performed prior to imaging and nerve conduction studies.…”

“…Both variants of AIN palsy can be identified clinically with the inability to form the ‘OK’ sign between the index finger and thumb, in the absence of sensory symptoms 3. It is also important to distinguish AIN palsy from tendon rupture, for example, of the FPL.…”

“…Furthermore, there is controversy around whether compressive injuries (as in this case) result in a transient neuritis which is best managed conservatively or whether a nerve entrapment plays a role; with a requirement for surgical decompression 2 3. All groups advocate conservative management initially, which usually comprises rest, removal of compressive precipitants and use of anti-inflammatories 3 5. However, the recommended time prior to surgical decompression for persisting paralysis ranges from 8 weeks to 2 years 6 17…”

“…On the basis of reviewed evidence, surgical management may be considered for patients showing no signs of recovery after a minimum of 12 months of conservative management 2 3…”

Nervenkompressionssyndrome

“…Zu den umstrittenen Kompressionssyndromen werden neben dem idiopathischen Tarsaltunnelsyndrom das Pronator-Syndrom, das Radialistunnelsyndrom, das Thoracic-outlet-und das Piriformis-Syndrom gezählt (Campbell und Landau 2008;Huang und Zager 2004;Presciutti und Rodner 2011;Rodner et al 2013). Sehr umstritten ist das sogenannte "algetische Supinatortunnelsyndrom" als Ursache eines therapieresistenten "Tennisellenbogens", bei dem eine Kompression des N. radialis bzw.…”