Abstract
Introduction: The posterior interosseous nerve (PIN) is the terminal branch of the deep branch of the radial nerve. It providing movement for the posterior forearm, controlling extension of the wrist and fingers. PIN injury severely affects hand function so it should be diagnosed and repaired promptly. Microsurgical repair of the PIN will recover the best results. The purpose of this study: evaluate the efficient of repairing posterior interosseous nerve by microsurgery.
Patients and methods: Retrospective and prospective study base on 21 patients with PIN injury who was performed microsurgery repair from 2018 to 2022. Assessment of recovery outcomes by using The Louisiana State University Health Science grading system – 2020 (LSUHS) and classified into 3 groups: Good (grade 4, 5); Fair (grade 3. 2); Poor (grade 0. 1).
Results: There are 14 men and 7 women, aged from 6 to 47. Cause by wounds: 12/21 cases, after previous surgery: 7/21 cases, nerve compression: 2/21 cases. Direct repair (nerve grafting): 20/21 cases, end-to-end neurorrhaphy were performed in: 1/21 case. Time follow-up ranged from 3 months to 60 months. Results: Good: 17/21 (80.95%) cases; Fair: 5/21 (19.05%) cases; Poor: no cases.
Conclusion: As results: Good: 17/21 (80.95%) cases; Fair: 5/21 (19.05%) cases; Poor: no cases. PIN injury severely affects hand function, so it should be diagnosed and repaired promptly by microsurgery.
Keywords: Posterior Interosseous Nerve, Nerve injury, Microsurgical peripheral nerve
Reference
- Sigamoney, K.V., A. Rashid, and C.Y. Ng, Management of atraumatic posterior interosseous nerve palsy. The Journal of hand surgery, 2017. 42(10): p. 826-830.
- Fujioka, H., et al., Surgical treatment of posterior interosseous nerve paralysis in a tennis player. J Orthop, 2014. 11(2): p. 110-2.
- Kim, D.H., et al., Surgical treatment and outcomes in 45 cases of posterior interosseous nerve entrapments and injuries. J Neurosurg, 2006. 104(5): p. 766-77.
- Iskender et al., Ultrasound Imaging for Complete Injury of the Posterior Interosseous Nerve After Forearm Surgery. American Journal of Physical Medicine & Rehabilitation, 2019. 98(6): p. e66.
- Ochi, K., et al., Surgical treatment of spontaneous posterior interosseous nerve palsy: a retrospective study of 50 cases. J Bone Joint Surg Br, 2011. 93(2): p. 217-22.
- Kalomiri D.E. et al, “Nerve grafting in peripheral nerve microsurgery of the upper extremity”, Microsurgery, 1994, Vol 15(7), pp. 506 – 511.
- Viet-Ngoc NGUYEN, Van-Doan LE et al., “Evaluation of the results of repairing the radial, median and ulnar nerve in the forearm by microsurgery”, Vietnam Medical Journal, 2010, Vol 374 (2), pp. 463 – 474.
- Brich R. Et al, “Repair of median and ulnar nerve. Primary suture is best“, J Joint Surg Br, 1991, Vol 73(1), pp. 154 – 157.
- Vodemvenne T. Et al, “Long-term results after primary microsurgical repair of ulnar and median nerve injuries A camparison of common score systems”, Clinical Neurology and Neurosurgery, 2007, Vol 109. Issue 3, pp. 263 – 271
- Eggers R, Tannemaat MR, Ehlert EM, Verhaagen J. A spatio-temporal analysis of motoneuron survival, axonal regeneration and neurotrophic factor expression after lumbar ventral root avulsion and implantation.Exp Neurol.2010;223:207–20.
- Hoke A, Redett R, Hameed H , et al. Schwann cells express motor and sensory phenotypes that regulate axon regeneration. J Neurosci. 2006;26:9646–55.
- Mackinnon S.E., Dellon A.L., “Anatomy and Physiology of the peripheral Nerve“, Surgery of the Peripheral Nerve, Thieme Medical Publishers, Inc, 1988, pp. 1 – 31.