전방골간신경 손상(anterior interosseous nerve injury)에 대하여

[문형철]

전방골간신경손상은 흔히 정중신경의 포착증후군으로 오인되지만 정확하게 구분해야 함. 

정중신경의 branch로 forearm의 전면 근육을 지배함. flexor digitorum profundus를 지배하지 않음.

그래서 전방골간신경문제가 발생한 환자는 OK 신호가 안됨.

Volar interosseous = ant interosseous nerve

The anterior interosseous nerve (volar interosseous nerve) is a branch of the median nerve that supplies the deep muscles on the front of the forearm, except the ulnar half of the flexor digitorum profundus.

It accompanies the anterior interosseous artery along the anterior of the interosseous membrane of the forearm, in the interval between the flexor pollicis longus and flexor digitorum profundus, supplying the whole of the former and (most commonly) the radial half of the latter, and ending below in the pronator quadratus and wrist joint.

Many texts, for simplicity's sake, consider this nerve part of the median nerve.

The anterior interosseous nerve classically innervates 2.5 muscles:

• flexor pollicis longus
• pronator quadratus
• the radial half of flexor digitorum profundus (the lateral two out of the four tendons).

These muscles are in the deep level of the anterior compartment of the forearm.

A branch of the median nerve, the anterior interosseous nerve (AIN) can be affected by either direct penetrating injury or compression in a fashion similar to carpal tunnel syndrome. The compression neuropathy is referred to an Anterior Interosseous Syndrome. As might be expected, the symptoms involve weakness in the muscle innervated by the AIN including the flexor digitorum profundus muscle to the index (and sometimes the middle) finger, the flexor pollicis longus muscle to the thumb and the pronator quadratus of the distal forearm. As opposed to carpal tunnel syndrome, the AIN has no sensory fibers and therefore no numbness associated with the Anterior Interosseous Syndrome. Non-surgical treatment consists of splinting, proximal tissue massage and anti-inflammatory drugs. Surgical treatment consists of releasing the compression on the nerve from surrounding structures. Pronator Syndrome is similar, but involves both the AIN as well as the median nerve proper.