Pathological Findings of Hourglass-Like Constriction in Spontaneous Posterior Interosseous Nerve Palsy.
Hourglass-like constriction
nerve graft
pathology
posterior interosseous nerve palsy
Journal
The Journal of hand surgery
ISSN: 1531-6564
Titre abrégé: J Hand Surg Am
Pays: United States
ID NLM: 7609631
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
14
11
2018
revised:
26
10
2019
accepted:
31
12
2019
pubmed:
11
3
2020
medline:
29
6
2021
entrez:
11
3
2020
Statut:
ppublish
Résumé
We report the pathological findings of hourglass-like fascicular constriction (HLFC) under optical and electron microscopy. A 24-year-old man with spontaneous posterior interosseous nerve palsy was treated by interfascicular neurolysis at 29 weeks after onset. One fascicle in the radial nerve presented severe HLFC with torsion at 5 cm proximal to the elbow. Functional recovery was achieved by resection of the enlarged fascicle including HLFC and sural nerve grafting. Proximal to the HLFC, the endoneurium was filled with clusters of regenerating nerve fibers. At the level of the HLFC, a complete loss of myelinated nerve fibers and vascular occlusion of endo- and perineurial vessels were found. Few regenerating nerve fibers were observed. Distal to the HLFC, severe endoneurial edema, a complete loss of myelinated and unmyelinated nerve fibers, and bands of Büngner were noted. These electron microscopic findings demonstrated a detailed pathology of the nerve around the HLFC.
Identifiants
pubmed: 32151406
pii: S0363-5023(20)30005-8
doi: 10.1016/j.jhsa.2019.12.011
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
990.e1-990.e6Informations de copyright
Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.