Anterior interrosseous nerve injury in a dumb bell lifter: A case report

 

 

Abstract              Background: Anterior interrosseous nerve syndrome is a rare compressive neuropathy of upperlimb. AIN is a motor branch of median nerve that innervates pronator quadrates, flexor pollicis longus and radial half of flexor digitorum profundus. The pathophysiology of AIN syndrome could be either a compressive neuropathy or immune mediated neuritis. Management options include non operative conservative management initially; if it is not responsive, surgical management could be tried. Dumbbell lifting usually causes carpal tunnel syndrome. Dumb bell lifting causing Anterior interrosseous nerve syndrome is a interesting presentation The Anterior interrosseous nerve nerve is a major motor branch of median nerve which is important for thumb and hand function. The AIN arises from median nerve, just inferior to elbow and innervates three muscles in the forearm, flexor pollicis lingus (FPL), pronator quadrates(PQ) and radial half of flexor digitorum profundus (FDP). AIN syndrome is a uncommon neuropathy of the upperlimb accounting for only 1% of upper limb nerve injuries³.AIN is a deep seated nerve protected by several structures which makes the AIN lesions rare. These protective structures could be the cause of its compression the Struthers ligament, bicipital aponeurosis, fibrous arches between humeral head and ulnar heads of pronator teres muscles, fibrous arch at the origin of flexor digitorum superficialis, vascular causes such as thrombosis, tumors, hematoma, abscesses, drug injection in to forearm, supra condylar fractures of humerus and proximal third of forearm⁴.AIN syndrome following lifting is a peculiar and a rare and presented here.