A rare case of fracture both bones of forearm complicated by combined anterior and posterior interosseuous nerve palsy

Abstract

Many traumatic and non-traumatic causes of isolated posterior interosseous nerve and anterior interosseous palsies have been reported in the literature. The common traumatic causes of posterior interosseous nerve palsy include Monteggia fractures, forearm lacerations, forearm contusions and penetrating injuries.1 and 5 Traumatic anterior interosseous nerve palsy is uncommon.3 Combined anterior and posterior interosseous nerve palsies are extremely rare. We report a case of combined anterior and posterior interosseous nerve palsy complicating an open fracture of radius and ulna of forearm. Case reportA 53-year-old male presented with history of injury to his left forearm when his boat toppled over while fishing. He presented to us 7nh after the injury. He was diagnosed to have open fracture of middle third of radius and ulna of left forearm. There were two lacerated wounds (i) 2ncmn×n1ncm over the volar aspect (ii) 2ncmn×n2ncm over the dorsoulnar aspect of upper third of the forearm.He was unable to extend the fingers and the thumb. The wrist extensors were acting. The sensations over the dorsal aspect of the first web space (autonomous zone of radial nerve) were intact. The flexor digitorum profundus of the index finger and flexor pollicis longus were not acting. The ulnar nerve was intact clinically. There was no stretch pain in both flexor as well as extensor compartments. X-rays of left forearm showed displaced fracture middle third of radius and ulna