[Posterior interosseous nerve palsy. A series of 18 cases and literature review]

Objectives: Posterior interosseous nerve palsy is a rare syndrome frequently unrecognized, while the clinical presentation is characteristic: finger extension paresis associated with wrist extension in radially deviated position. Here, we assessed our results of surgical treatment.

Methods: A 20-year retrospective study was carried out in our unit. Analysis of causes and an assessment of postoperative functional outcome were performed. Our study was compared with literature data.

Results: Eighteen cases were treated with a predominance in men manual workers. The etiology of the posterior interosseous nerve palsy was tumor in four cases, traumatic in two cases, iatrogenic in two cases and idiopathic in ten cases. In seven of these ten cases, compression under the arch of the extensor carpi radialis brevis was found. The postoperative results were satisfactory with full recovery in nine out of fifteen cases treated by neurolysis, depending on the duration of the paralysis. In the literature, we found 264 cases over 50 years through a variety of clinical cases and five case series. A predominance of tumor etiology was found.

Conclusion: Ignorance of the clinical presentation of a posterior interosseous nerve palsy frequently leads to misdiagnosis. Early complete neurolysis enables a satisfactory functional recovery.