Purpose
The posterior interosseous sensory nerve innervates the dorsal capsule of the wrist,
which may provide nociceptive and proprioceptive sensation. Posterior interosseous
sensory neurectomy (PISN) is commonly used as a primary or adjunctive procedure to
provide wrist analgesia for a variety of wrist conditions. Currently, there is little
information in the literature regarding the proprioceptive role of the posterior interosseous
sensory nerve and the resultant effects of PISN on wrist proprioception. The purpose
of our investigation was to examine the effect of PISN on wrist proprioception.
Methods
For 23 consecutive patients who had posterior interosseous sensory neurectomy, proprioception
of their surgical wrists was compared to their nonsurgical wrists as well as to the
normal wrists of 23 healthy volunteers. Using a custom testing device, wooden dowels
were used to set subjects' wrists at specific angles within the testing jig, and then
subjects were asked to mimic the position with their other hand at the following angles:
neutral (0°), flexion (20°, 40°, 60°), extension (20°, 40°, 60°), 10° of radial deviation,
and 10° of ulnar deviation. The following statistical comparisons were made:
1
patients' surgical versus controls' assessed wrists and
2
patients' surgical wrists versus patients' nonsurgical wrists.Results
There were no statistically significant differences in wrist proprioception except
in 40° of extension with more accurate estimations by surgical wrists when compared
to control wrists.
Conclusions
Posterior interosseous sensory neurectomy does not appear to be associated with decreased
proprioception of the wrist as measured by a custom testing device.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Accepted:
October 15,
2009
Received:
May 16,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Proprioception of the Wrist Following Posterior Interosseous Sensory NeurectomyJournal of Hand SurgeryVol. 35Issue 4
- PreviewIt was with great interest that I read the article on proprioception of the wrist following posterior interosseous sensory neurectomy (PINS), and I would like to congratulate the authors on performing one of the first case-control studies on wrist proprioception.1 The authors conclude their article by stating, “Posterior interosseous sensory neurectomy is not associated with diminished wrist proprioception,” and I believe that this conclusion merits further explanation.
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