Abstract
Anterior interosseous nerve syndrome (Kiloh-Nevin Syndrome) is the triad of weakness
of the flexor pollicis longus, the flexor digitorum profundus of the index finger,
and the pronator quadratus. It is a manifestation of neuropathy affecting either the
anterior interosseous nerve itself (anterior interosseous neuropathy) or its fascicles
more proximally within the median nerve or brachial plexus (pseudo–anterior interosseous
neuropathy). Anterior interosseous neuropathy in the presence of normal anatomic variation
of the anterior interosseous nerve must be distinguished clinically from pseudo–anterior
interosseous neuropathy, which can present with telltale signs in addition to the
signature weaknesses of anterior interosseous nerve syndrome. A history of penetrating
injury mitigates toward early exploration and nerve repair. A history of sudden onset
and rapid progression, particularly when accompanied by a prodrome of pain and fatigue,
suggests the presence of a focal neuritis, which typically resolves completely within
6 to 12 months without surgical intervention. If no improvement is noted within 6
to 12 months or if the neurologic condition worsens, surgical exploration may be warranted.
In the presence of untreatable injury to the anterior interosseous nerve, with permanent
muscular atrophy, functional tendon transfers of the flexor digitorum superficialis
of the ring or middle finger or of the brachioradialis may be helpful. Copyright ©
2001 by the American Society for Surgery of the Hand
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References
References
- Nerve wounds.William Wood, New York1918
- Isolated neuritis of the anterior interosseous nerve.BMJ. 1952; 1: 850-851
- Neuralgic amyotrophy: the shoulder-girdle syndrome.Lancet. 1948; 1: 973-978
- The anterior interosseous nerve paralysis as a complication of supracondylar fractures in children.J Bone Joint Surg Am. 1969; 51A: 1584-1590
- Incidence of anterior interosseous nerve palsy in supracondylar humerus fractures in children.J Ped Orthop. 1993; 13: 502-505
- Anterior interosseous nerve palsy complicating a forearm fracture in a child.J Hand Surg [Am]. 1990; 15A: 44-47
- Combined entrapment of the median and anterior interosseous nerves in a pediatric both-bone forearm fracture.J Orthop Trauma. 1990; 4: 197-199
- Entrapment and transection of the median nerve associated with greenstick fractures of the forearm: case report and review of the literature.J Trauma. 1998; 44: 1101-1102
- An anomaly of the median artery associated with the anterior interosseous nerve.J Hand Surg [Br]. 1992; 17: 507-509
- Anterior interosseous nerve syndrome associated with forearm band treatment of lateral epicondylitis.Orthopedics. 1991; 14: 788-790
- Anterior interosseous nerve syndrome secondary to forearm thrombo-phlebitis.Ital J Neurol Sci. 1989; 10: 221
- Anterior interosseous nerve syndrome: unusual etiologies.Arch Phys Med Rehabil. 1983; 64: 182
- Pseudo-anterior interosseous nerve syndrome.Muscle Nerve. 1985; 8: 68-70
- Compression neuropathies: median.McGraw-Hill, New York1996
- The innervation of the flexor digitorum profundus and lumbrical muscles.Anat Rec. 1945; 93: 317-321
- The intraneural topography of the radial, median, and ulnar nerves.Brain. 1945; 68: 243-299
- Variations in innervation of the flexor digitorum profundus muscle.J Hand Surg [Am]. 1999; 24: 700-703
- The internal anatomy of the median nerve in the region of the elbow.J Hand Surg [Am]. 1992; 17: 456-648
- Nerves and nerve injuries. 660. Churchill Livingstone, Edinburgh1978 (695-696)
- The anterior interosseous nerve syndrome. With special attention to its variations.J Bone Joint Surg Am. 1970; 52A: 84-94
- The incomplete anterior interosseous nerve syndrome.J Hand Surg [Am]. 1985; 10: 4-16
- The anterior interosseous nerve syndrome (the Kiloh-Nevin syndrome). Report and follow-up study of three cases.Clin Orthop Rel Res. 1984; 187: 223-227
- Brachial neuritis.J Bone Joint Surg Am. 1985; 67A: 878-880
- Injuries to the major branches of peripheral nerves of the forearm.Saunders, Philadelphia1978 (160-227)
- Focal peripheral neuropathies.Lippincott Williams and Wilkins, New York2000 (183-239)
- Third annual report on the Committee of Collective Investigation of the Anatomical Society of Great Britain and Ireland for the year 1891-1892.J Anat Physiol. 1893; 27: 183-194
- Studies on the hand in ulnar nerve paralysis: a clinical-experimental investigation in normal and anomalous innervation.Acta Orthop Scand. 1966; 87: 1-176
- Der Nervus Medianus.Beitr Klin Chir. 1917; 107: 553-582
- Tendon ruptures with scaphoid nonunion. A case report.Clin Orthop Rel Res. 1990; 255: 117-120
- Attritional flexor tendon rupture due to a scaphoid nonunion imitating an anterior interosseous nerve syndrome: a case report.J Hand Surg [Br]. 1985; 10: 62-64
- Anterior interosseous nerve syndrome presenting with pronator teres weakness: a case report.Muscle and Nerve. 1997; 20: 1591-1594
- Nonoperative treatment of anterior interosseous nerve paralysis.J Hand Surg [Am]. 1990; 15: 493-496
- Anterior interosseous nerve palsy: a review of 16 cases.J Hand Surg. 1997; 22: 64-68
Article info
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1531-0914/01/0104-0004$35.00/0
Identification
Copyright
© 2001 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
