Posterior Interosseous Nerve Release - Standard

Posterior Interosseous Nerve Release - Standard
Authors: Mackinnon SE1, Yee A1
Published: August 27, 2013

AUTHOR INFORMATION
1 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Compression of the posterior interosseous nerve can exhibit clinical weakness or functional loss of finger / thumb extension and lack of ulnar wrist extension. Provocative tests can confirm whether the radial tunnel in the region of the posterior interosseous nerve is the area of compression. Multiple anatomical structures can be involved in compressing the nerve in the tunnel, however the primary site of compression is the arcade of Froshe; this being the tendinous proximal border of the superficial head of the supinator. Other compressive structures can include the radial recurrent vessels (Leash of Henry) and tendinous proximal border of the extensor carpi radialis brevis. Decompression of the posterior interosseous nerve involves releasing these structures. If there is an associated lateral epicondylitis, release of the extensor carpi radialis brevis is taken further laterally. In this case, this patient presented with a recovering traumatic C7,8,T1 plexus injury. However, recovery of radial nerve function was halted for a few weeks with marked discomfort over the radial tunnel. Release of the posterior interosseous nerve was elected to promote more prompt and complete functional recovery.