Treatment of dysesthesia of the sensory branch of the radial nerve by distal posterior interosseous neurectomy

Proprioception of the Wrist Following Posterior Interosseous Sensory Neurectomy

“…In several series of partial and extensive wrist denervations with follow-up ranging from 2 to 5 years, no changes resembling Charcot arthropathy were observed. 6,10,14,23 In another series, no sensory or functional deficits related to PISN were reported. 23 Weinstein et al 8 reported that none of their 19 patients who had partial wrist denervation (anterior and posterior interosseous neurectomies) complained of an altered sense of joint position.…”

“…4,8,10,14,23 In a review of 313 patients, of which 30 patients had complete wrist denervation and 195 patients were followed for more than 4 years, Buck-Gramcko 4 reported no radiographic evidence of Charcot joints. In several series of partial and extensive wrist denervations with follow-up ranging from 2 to 5 years, no changes resembling Charcot arthropathy were observed.…”

Denervation of the Wrist

“…This procedure also removes a resistant dysesthesia observed in isolated injuries of the sensory branch of the radial nerve. 37 The prognosis of denervation commonly is better the more circumscribed and limited the pain.…”

The accuracy of distal posterior interosseous and anterior interosseous nerve injection

“…5 Local anesthetic injections are advocated as a key to the presurgical evaluation in patients with chronic wrist pain to determine which patients will benefit from partial wrist denervation. [2][3][4][5]13,14 Isolated PIN injection or combined PIN/AIN injections can be performed. In an initial office visit the PIN can be injected and monitored with a pain diary.…”