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- 주제어 : Posterior interosseous nerve syndrome (검색결과 5 건)
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측와위로 시행한 견관절 관절경 후에 동시에 발생한 전방 및 후방 골간 신경 증후군
서재성(Jae Sung Seo),김지훈(Jee Hoon Kim),강동화(Dong Hwa Kang) 대한견주관절의학회 2013 대한견주관절학회지 Vol.16 No.2
관절 관절경으로 수술적 치료를 시행한 후 전방 및 후방 골간 신경 증후군이 동시에 발생한 1예를 보고하고자 한다. 45세 남자 환자가 좌측 견관절의 불안정성으로 견관절 관절경 수술을 시행받았다. 전신 마취하 우측 측와위 자세에서 전완부를 신전한 상태에서 견인 장치를 부착한 상태로 2시간 동안 수술을 시행하였다. 1주일 후 환자는 좌측 전완부 동통, 수지의 신전력 및 무지와 인지의 심수지 굴근력의 저하로 외래를 방문하였다. 경과 관찰하였으나 증상이 지속되어 전방 골간 신경에 대해서는 신경 탐색술을 시행하였고 후방 골간 신경에서는 모래 시계 모양의 협착 소견이 발견되어 병변 절제 후 신경 외막 봉합술을 시행하였다. 수술 후 약 5개월간 외래에서 경과 관찰하였다. 신경 탐색술을 시행하고 3개월 후 총수지 신근의 기능이 회복하기 시작하였으며, 점차 회복하여 신경 탐색술 후 5개월째 증상이 완전히 회복되었다. 견관절 관절경 수술 후 전방 및 후방 골간 신경 증후군의 발생은 드물지만 견인 장치 및 수술 중 자세에 의해 유발될 수 있다. 따라서 견인 장치 부착 및 수술 자세에 대해 술자의 주의가 필요하다고 생각한다. We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.
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Ultrasonographic findings of posterior interosseous nerve syndrome
김유동,하두회,이상민 대한초음파의학회 2017 ULTRASONOGRAPHY Vol.36 No.4
Purpose: The purpose of this study was to evaluate the ultrasonographic findings associated with posterior interosseous nerve (PIN) syndrome. Methods: Approval from the Institutional Review Board was obtained. A retrospective review of 908 patients' sonographic images of the upper extremity from January 2001 to October 2010 revealed 10 patients suspicious for a PIN abnormality (7 male and 3 female patients; mean age of 51.8±13.1 years; age range, 32 to 79 years). The ultrasonographic findings of PIN syndrome, including changes in the PIN and adjacent secondary changes, were evaluated. The anteroposterior diameter of the pathologic PIN was measured in eight patients and the anteroposterior diameter of the contralateral asymptomatic PIN was measured in six patients, all at the level immediately proximal to the proximal supinator border. The size of the pathologic nerves and contralateral asymptomatic nerves was compared using the Mann-Whitney U test. Results: Swelling of the PIN proximal to the supinator canal by compression at the arcade of Fröhse was observed in four cases. Swelling of the PIN distal to the supinator canal was observed in one case. Loss of the perineural fat plane in the supinator canal was observed in one case. Four soft tissue masses were noted. Secondary denervation atrophy of the supinator and extensor muscles was observed in two cases. The mean anteroposterior diameter of the pathologic nerves (n=8, 1.79±0.43 mm) was significantly larger than that of the contralateral asymptomatic nerves (n=6, 1.02±0.22 mm) (P=0.003). Conclusion: Ultrasonography provides high-resolution images of the PIN and helps to diagnose PIN syndrome through visualization of its various causes and adjacent secondary changes
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Han, Bo Ram,Cho, Yong Jun,Yang, Jin Seo,Kang, Suk Hyung,Choi, Hyuk Jai The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.55 No.3
Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.
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Posterior Interosseous Neuropathy Caused by Torsion due to Leash of Henry: A Case Report
이해인,김단,김동휘,박종웅,권희규 대한근전도전기진단의학회 2019 대한근전도 전기진단의학회지 Vol.21 No.1
A 34-year-old man was referred for electrodiagnosis of left forearm and elbow pain with concurrent left wrist and finger extension weakness. Symptom developed abruptly, after waking up from sleep. After 11 days of onset, electromyography was performed. In nerve conduction study, the left radial motor response was unobtainable and in needle electromyography, abnormal spontaneous activities and no motor unit potential were noted in the left supinator, extensor digitorum communis, extensor carpi ulnaris and extensor indicis proprius muscles, suggesting left posterior interosseous neuropathy involving the supinator muscle and all the distal muscles to it. Subsequent ultrasonography of the left upper arm revealed multiple nerve torsions, and surgical exploration finally confirmed that the main torsion site was caused by the recurrent branch of radial artery, the Leash of Henry. We report an unusual case of spontaneous posterior interosseous nerve neuropathy due to nerve torsion caused by Leash of Henry.
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Neuralgic Amyotrophy Manifesting as Mimicking Posterior Interosseous Nerve Palsy
Yang, Jin Seo,Cho, Yong Jun,Kang, Suk Hyung,Choi, Eun Hi The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.58 No.5
The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies.
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