title: Anterior interosseous nerve syndrome diagnosis and intraoperative findings: A case report.
abstract: BACKGROUND
  Anterior Interosseous Nerve (AIN) is a motor branch from the Median nerve and runs deep in the forearm along with the anterior interosseous artery. It innervates three muscles in the forearm; an isolated palsy of these muscles is known as AIN Syndrome. There are several documented causes of AIN syndrome but its pathophysiology remains unclear.
  
  
  METHODS
  A 48-year old male that presented with right elbow pain and inability to flex his right interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger. MR images denoted mild atrophy of the radial half of the flexor digitorum profundus and the pronator quadratus. Although there were no compressing lesions identifiable on MRI, Electrodiagnostic studies suggested compression neuropathy affecting the AIN. During surgical decompression of the median nerve in the proximal forearm, the operative findings were several tendinous fasciae and a tight fibrous arch of the flexor digitorum superficialis compressing the median nerve at the level of the AIN branch.
  
  
  CONCLUSIONS
  Different treatment schemes with reasonable outcome have been reported. Both nonsurgical and surgical intervention have been described in most of these schemes but differed in the timing of intervention with variable outcome.
  
  
  CONCLUSIONS
  Clinical suspicion should arise in the presence of isolated paralysis of the AIN-supplied muscles. MRI and electrodiagnostic studies will confirm the diagnosis and identify the etiology. The optimal treatment of AIN syndrome has not been established. We recommend surgical intervention in confirmed AIN syndrome from compression neuropathy, refractive to conservative therapy.
authors.affiliation: Department of Orthopaedic Surgery, Bahrain Defence Force Hospital-Royal Medical Services, P.O.Box 28743, Riffa, Bahrain. Electronic address: draaljowder@gmail.com.
authors.forename: Abdulla
authors.initials: A
authors.lastname: Aljawder
authors.affiliation: Department of Orthopaedic Surgery, Bahrain Defence Force Hospital-Royal Medical Services, P.O.Box 28743, Riffa, Bahrain.
authors.forename: Mohammed Khalid
authors.initials: MK
authors.lastname: Faqi
authors.affiliation: Department of Orthopaedic Surgery, Bahrain Defence Force Hospital-Royal Medical Services, P.O.Box 28743, Riffa, Bahrain.
authors.forename: Abeer
authors.initials: A
authors.lastname: Mohamed
authors.affiliation: Department of Orthopaedic Surgery, Bahrain Defence Force Hospital-Royal Medical Services, P.O.Box 28743, Riffa, Bahrain.
authors.forename: Fahad
authors.initials: F
authors.lastname: Alkhalifa
keywords: Anterior; Case report; Interosseous; Nerve; Neuropathy; Palsy