Anterior interosseous nerve


Motor Innervation of Anterior Interosseous Nerve
Motor flexor digitorum profundus - radial half flexor pollicis longus pronator quadratus Sensory none Reflex none
Origin & Branches
C5-T1 roots medial and lateral cord of brachial plexus median nerve AIN branch to FDP branch to FPL branch to pronator quadratus
Course
Branch from median nerve branches from median nerve 4cm distal to medial epicondyle it runs along the front of the interosseous membrane of the forearm in the interval between the flexor pollicis longus and flexor digitorum profundus it terminates distally in the pronator quadratus and wrist joint.
Clinical Conditions
Anterior interosseous syndrome Pediatric supracondylar fractures

TAG

(OBQ11.255) A 4-year-old male falls from monkey bars and sustains an extension supracondylar humerus fracture with a neurologic deficit. Which of the following muscles is most likely affected? Topic

Review Topic

1. Extensor digitorum communis
2. Pronator quadratus
3. Flexor carpi radialis
4. Flexor digitorum profundus to small/ring fingers
5. Flexor carpi ulnaris

PREFERRED RESPONSE ▶

DISCUSSION: Anterior interosseous nerve injury is the most common nerve injury seen in extension type supracondylar humerus fractures in children. The anterior interosseous nerve innervates flexor pollicis longus, flexor digitorum profundus to the index and long fingers and pronator quadratus.

Seror describes a consecutive series of 13 patients with lesions of the anterior interosseous nerve. Based on the difficulty of diagnosis and evaluation, these patients are most frequently misdiagnosed with tendon injuries. In his series, only 3 patients had a correct initial clinical diagnosis, and the most common electrophysiological abnormality found was in the innervation of pronator quadratus.

REFERENCES:

1. Seror P. Anterior interosseous nerve lesions. Clinical and electrophysiological features. J Bone Joint Surg Br. 1996 Mar;78(2):238-41. PMID:8666633 (Link to Abstract)

2. MacKinnon SE, Novak CB: Compression neuropathies, in Green DP, Hotchkiss RN, Pedersen WC, et al (eds): Green's Operative Hand Surgery. 5th ed.Philadelphia, PA: Elsevier Churchill Livingstone; 2005:1019.

Question Authors:

Patrick O'Donnell MD/PhD, John Badylak MD, Ben Taylor MD,

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Level of Evidence 4 (Case Series)

Seror P. Anterior interosseous nerve lesions. Clinical and electrophysiological features. J Bone Joint Surg Br. 1996 Mar;78(2):238-41. PMID:8666633 (Link to Abstract)

Textbooks

Review of Orthopaedics, 6th Edition, Mark D. Miller MD, Stephen R. Thompson MBBS MEd FRCSC, Jennifer Hart MPAS PA-C ATC, an imprint of Elsevier, Philadelphia, Copyright 2012
AAOS Comprehensive Orthopaedic Review, Jay R. Leiberman. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2009
Orthopaedic Knowledge Update 10, John M Flyn. Published by American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2011
Hoppenfeld SP. Surgical Exposures in Orthopaedics: The Anatomic Approach. Lipponcott, Williams, and Wilkins, Philadelphia, PA, Copyright 2009
Orthopaedic In-training Examination (OITE) Questions 2004-2012, American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2004-2012
Self-Assessment Examination (SAE) Questions 2004-2012, American Academy of Orthopaedic Surgeons, Rosemont IL. Copyright 2004-2012
MacKinnon SE, Novak CB: Compression neuropathies, in Green DP, Hotchkiss RN, Pedersen WC, et al (eds): Green's Operative Hand Surgery. 5th ed.Philadelphia, PA: Elsevier Churchill Livingstone; 2005:1019.

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