title: Isolated anterior interosseous nerve deficit due to a false aneurysm of the humeral artery: an unusual complication of penetrating arm injury. Case report and literature review.
abstract: Anterior interosseous nerve (AIN) injuries account for only 1% of all the nerve injuries at the upper limb. We report the case of a 22-year-old male who sustained a penetrating injury to the arm. No neurological deficit was found at the initial evaluation. However, 6 weeks later, he had a motor deficit confined to the territory of the AIN with weakness of the flexor pollicis longus and flexor digitorum longus to the index. He also reported paraesthesia. Tinel's test was positive over the pinpoint wound in the arm, where a painful swelling was felt. Electroneurophysiological testing indicated a deficit of the AIN. Surgical exploration identified a thrombosed false aneurysm of the humeral artery responsible for compression of the median nerve. One month later, the patient had achieved a full recovery. Immediate routine exploration of deep penetrating wounds, although mandatory, may fail to detect any lesions. Close monitoring must be provided subsequently, as gradual nerve compression can result in delayed neurological deficits.
authors.affiliation: Service de chirurgie orthopédique, hôpital Pellegrin, place Amélie-Raba-Leon, 33076 Bordeaux cedex, France. Electronic address: bertrand.dunet@wanadoo.fr.
authors.forename: B
authors.initials: B
authors.lastname: Dunet
authors.forename: J
authors.initials: J
authors.lastname: Pallaro
authors.forename: F
authors.initials: F
authors.lastname: Boullet
authors.forename: C
authors.initials: C
authors.lastname: Tournier
authors.forename: T
authors.initials: T
authors.lastname: Fabre
mesh_terms: D017541:Aneurysm, False / Q000150:complications*; D001132:Arm / Q000294:innervation*; D001134:Arm Injuries / Q000150:complications*; D006801:Humans; D006811:Humerus / Q000098:blood supply*; D008297:Male; D020423:Median Neuropathy / Q000209:etiology*; D009408:Nerve Compression Syndromes / Q000209:etiology*; D014950:Wounds, Penetrating / Q000150:complications*; D055815:Young Adult
keywords: Anterior interosseous nerve; Compression; False aneurysm; Median nerve; Nerve