Clinical Neurophysiology, St Vincent's University Hospital, Dublin, Ireland
Plastic and Reconstructive Surgery, St Vincent's University Hospital, Dublin, Ireland.
BMJ Case Rep. 2021 Oct 1;14(10):e245659. doi: 10.1136/bcr-2021-245659.
The posterior interosseous nerve is the terminal motor branch of the radial nerve that innervates the extensor carpi ulnaris and the extensors of the thumb and fingers. We describe a case of a posterior interosseous neuropathy presenting with the typical 'finger drop' and partial 'wrist drop'. We focus on the clinical signs that distinguish it from a more proximal radial neuropathy, clarified by nerve conduction studies and needle electromyography. Multimodal imaging of the forearm did not identify a compressive lesion. Persistent symptoms prompted surgical exploration 5 years after initial onset. It identified compression of the posterior interosseous nerve in the region of the arcade of Frohse and leash of Henry. The sites were decompressed and concurrent salvage secondary reconstructive tendon transfers were required in view of the severe axonal loss with minimal chance of functional reinnervation.
骨间后神经是桡神经的终末运动支，支配尺侧伸腕肌和拇指及手指的伸肌。我们描述了一例表现为典型“垂腕”和部分“腕下垂”的骨间后神经病变。我们重点介绍了通过神经传导研究和针极肌电图检查可明确区分其与更靠近近端的桡神经病变的临床特征。前臂的多种模态成像未发现压迫性病变。持续存在的症状促使在初次发病后 5 年进行手术探查。术中发现桡神经骨间后神经在 Frohse 弓和 Henry 腱弓区域受压。这些部位被减压，由于轴索丢失严重，几乎没有功能再支配的机会，因此需要进行同时的挽救性二次重建肌腱转移。
