Anterior Interosseous Syndrome or Kiloh-Nevin Syndrome I is a condition where there is injury or damage to the anterior interosseous nerve resulting in pain and weakness in the forearm. This is a form of entrapment neuropathy of the anterior interosseous nerve. This nerve is a branch of median nerve. The anterior interosseous nerve passes through the forearm and innervates the long flexor muscles, FPL muscles, and the pronator quadratus. Treatment comprises of conservative methods such as rest, splinting, pain medications, PT and corticosteroid injections. If symptoms still persist, then surgical decompression of the nerve is done.
Signs of Anterior Interosseous Syndrome or Kiloh-Nevin Syndrome
- Impaired movement of index and middle finger.
- Impaired flexion of thumb, index, and middle finger.
- Weakness in the index and middle fingers.
- Experience of pain in upper forearm and sometimes in the elbow.
- Patient is not able to perform the pincer movement of the thumb and index finger i.e. the patient is not able to flex or hold anything between thumb and index finger.
Causes of Anterior Interosseous Syndrome or Kiloh-Nevin Syndrome
The causes of the nerve compression in the forearm are numerous such as:
- Increased size of biceps tendon bursa.
- Supracondylar fractures and other injuries inclusive of dislocations.
- Thrombosis of the radial and/or ulnar arteries can also cause nerve compression.
- Direct injury or trauma can also cause nerve compression.
- Fibrous bands or arcuate ligaments can also compress the anterior interosseous nerves causing pain.
- Patients with rheumatoid disease and gouty arthritis are more prone to developing anterior interosseous syndrome.
Diagnosis for Anterior Interosseous Syndrome or Kiloh-Nevin Syndrome
- Nerve conduction studies
- Electromyography (EMG)
- Ultrasound imaging
Treatment of Anterior Interosseous Syndrome or Kiloh-Nevin Syndrome
- Rest is important.
- Splinting can be done for immobilization.
- Anti-inflammatory drugs to help calm down the pain.
- Sports massage helps in reducing stiffness in the muscles.
- Patient should enroll in a physical therapy program.
- Gentle stretching exercises can be done.
- If symptoms persist, then steroid injections can be given.
- If patient does not benefit from conservative treatment, then surgery is done to release the compression on the nerve.