![]() ![]() The exact protocol for AIN treatment remains unclear.Specifically, AIN is most commonly reported following fractures and crush injuries. Certain activities such as buttoning a shirt, holding a pen, and grasping keys to turn on the car may be particularly difficult.Īn injury to the anterior interosseous nerve most commonly occurs with complex trauma, whereas an isolated injury is rare. Another provocative test that could be performed is the pinch test where the patient will not be able to pinch a piece of paper with thumb and index finger. On physical exam, this can appear by the patient being unable to touch the thumb to the index finger to make an “OK” sign. There is no cutaneous branch, so neuropathy presents with muscle weakness and no sensory deficits. The anterior interosseous nerve innervates the flexor pollicis longus, pronator quadratus, and the deep flexors of digits two and three. The anterior interosseous branch of the median nerve is located at the elbow then moves into the anterior forearm. ![]() Elbow orthosis fabrication – should be worn 4-6 weeksĪnterior Interosseous Neuropathy (AIN Palsy).Rest – decreasing overuse is crucial to recovery.The Phalen maneuver and the Tinel sign are also often negative in pronator syndrome. The presence of pronator syndrome can involve loss of sensation over the thenar eminence due to nerve compression. Athletes that participate in weightlifting, rowing, and those that use rackets are also at risk. Common job roles that are especially prone to developing pronator syndrome include carpenters and mechanics. Pronator syndrome is often a result of recurrent, forceful gripping, forearm rotation, or elbow flexion, however, certain underlying conditions such as hypothyroidism and diabetes are considered risk factors as well. These are typically most noticeable and bothersome when trying to rotate the palms from facing upward to turning down towards the floor. When this nerve becomes entrapped at the elbow, a number of symptoms can present themselves. The median nerve begins in the upper arm and its branches extend into the fingers. Pronator syndrome occurs when the median nerve is compressed in the upper forearm as it passes along the elbow joint into the forearm compartment between the two heads of pronator teres. Signs may be difficulty handling small objects or having a tendency to easily drop objects. Can cause loss of feeling, strength, and dexterity. Signs may be loss of motor control in the thumb, index, and middle fingers.Ĭompressed at the elbow, under the lacertus fibrosus. Identified by the inability to form the “OK” sign. Signs include bothersome sensations when trying to rotate in supination and pronationĬompression of the anterior interosseous branch of the median nerve. Result of recurrent, forceful gripping, forearm rotation, or elbow flexion. Aside from the most common upper extremity nerve compression, carpal tunnel syndrome (CTS), there are several additional median nerve injuries.Ĭompression of the median nerve between the two heads of pronator teres. ![]()
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