Kesserwani Hassan
Neurology, Flowers Medical Group, Dothan, USA.
Cureus. 2021 May 22;13(5):e15180. doi: 10.7759/cureus.15180.
Precision grip, a prehensile function of humans, is exacted through the action of the median nerve and its main tributary, the anterior interosseus nerve (AIN). In the forearm, the AIN can be subject to nerve entrapment by tendinous and fibrous arches or accessory and variant muscles. It is also vulnerable to trauma of the upper arm and forearm. To the neurologist, an isolated neuritis or an immune-mediated medial cord or lower trunk brachial plexopathy (Parsonage-Turner syndrome) is the usual mode of presentation. When the spread of muscle weakness is beyond the territory of the AIN, the syndrome is referred to as a pseudo-AIN. The AIN is grouped into fascicles that are compartmentalized separately from the median nerve proper, and trauma in the upper arm may selectively involve the AIN. We present a case of pseudo-AIN following elbow arthroscopic surgery and outline the pathology, clinical signs, and functional anatomy of the AIN and the precision grip.
精确抓握是人类的一种抓握功能,通过正中神经及其主要分支骨间前神经(AIN)的作用来实现。在前臂,AIN可能会受到腱性和纤维性弓或副肌及变异肌肉的神经卡压。它也容易受到上臂和前臂创伤的影响。对神经科医生来说,孤立性神经炎或免疫介导的内侧束或臂丛下干神经病(Parsonage-Turner综合征)是常见的表现形式。当肌无力的范围超出AIN支配区域时,该综合征被称为假性AIN。AIN被分成束,与正中神经主干分开分区,上臂的创伤可能会选择性地累及AIN。我们报告一例肘关节镜手术后发生假性AIN的病例,并概述AIN的病理学、临床体征、功能解剖以及精确抓握。