Vikas Vikas, Bhatia Naval, Garg Jyoti
Central Institute of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, 110029, India.
Oncquest Laboratories, New Delhi, 110055, India.
J Clin Orthop Trauma. 2020 Feb;11(Suppl 1):S174-S176. doi: 10.1016/j.jcot.2019.10.006. Epub 2019 Oct 17.
Entrapment of posterior interosseous nerve (PIN) can be due to fracture dislocation of elbow, fibrous arcade of Frohse, neoplasms (lipoma, schwannoma), ganglion cysts and rheumatoid synovitis. Parosteal lipomas are extremely rare. These tumors grow slowly and as they grow, they can compress a nearby nerve producing sensory and motor disturbances. Till date less than 50 cases of PIN entrapment due to parosteal lipoma have been reported in literature. However, to the best of our knowledge, none was bilobed. A 54-year-old female patient presented with progressive weakness of the right-hand extensors including thumb for the last 5 months with no sensory loss. Clinico-radiological findings and electophysiological studies revealed parosteal lipoma causing entrapment of PIN. Surgical excision of the lesion was done through posterior approach. The excised mass was sent for histopathological examination which confirmed the diagnosis of lipoma. Appreciable recovery was first noticed at 3 months and complete recovery was seen at 7 months. No recurrence was seen until 2 years of follow up. Urgent surgical excision is necessary to prevent entrapment of this nerve and facilitate early functional and neurological recovery.
骨间后神经（PIN）卡压可由肘部骨折脱位、弗罗瑟纤维弓、肿瘤（脂肪瘤、神经鞘瘤）、腱鞘囊肿和类风湿性滑膜炎引起。骨膜下脂肪瘤极为罕见。这些肿瘤生长缓慢，随着生长，它们会压迫附近神经，产生感觉和运动障碍。迄今为止，文献报道因骨膜下脂肪瘤导致的PIN卡压病例不到50例。然而，据我们所知，尚无双侧叶状的病例。一名54岁女性患者在过去5个月中出现右手伸肌包括拇指进行性无力，无感觉丧失。临床影像学检查和电生理研究显示骨膜下脂肪瘤导致PIN卡压。通过后路手术切除病变。切除的肿块送去做组织病理学检查，确诊为脂肪瘤。术后3个月首次出现明显恢复，7个月时完全恢复。随访2年未见复发。紧急手术切除对于防止该神经卡压并促进早期功能和神经恢复是必要的。
