ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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OLGU SUNUMLARI

Posterior İnterosseöz Sinir Nöropatisi: İki Olgu Sunumu ve Literatürün Gözden Geçirilmesi
Posterior Interosseous Nerve Neuropathy: Two Case Reports and Review of the Literature
Received Date : 22 Mar 2024
Accepted Date : 13 Oct 2024
Available Online : 23 Oct 2024
Doi: 10.31609/jpmrs.2024-102950 - Makale Dili: TR
Turkiye Klinikleri Fiziksel Tip Ve Rehabilitasyon Bilimleri Dergisi. 2025;28(1):93-8
ÖZET
Radial nöropatiler sinirin seyri boyunca aksilla düzeyi ve spiral oluk düzeyi nöropatiler, posterior interosseöz sinir ve süperfisyal radial sinir nöropatisi olarak dört bölgede görülür. Bu lezyonların ayırıcı tanısında sıklıkla klinik bulgular yeterli ve yol gösterici olmakla beraber elektrofizyolojik incelemeler lezyon yerinin net lokalizasyonu, lezyon şiddeti ve prognoz hakkında ayrıntılı bilgi vermesi nedeniyle önemlidir. Posterior interosseöz sinir sendromu üst ekstremite periferik sinir tuzak nöropatilerinin %0,7’sinden daha azını oluşturur ve posterior interosseöz sinir saf motor dal olduğu için duyusal kayıp olmadan ekstansör karpi ulnaris ve distalindeki parmak ekstansörlerinde güçsüzlük tespit edilir. Sinirin supinatör kasta sıkışması, nöraljik amiyotrofi, yer kaplayan lezyonların eksternal basısı, dirsek eklemindeki şekil bozukluklarının, Monteggia kırıklarında travmatik yaralanmaya bağlı olarak nöropati görülebilir. Bu olgu sunumunda oldukça nadir karşılaşılan parsiyel posterior interosseöz sinir nöropatisinin radial sinir tuzak nöropatilerinde ayırıcı tanıda akılda tutulması, elektrodiagnostik incelemelerin tanısal önemi ve tedavi yaklaşımlarının literatür bilgileri ışığında sunulması amaçlanmıştır.
ABSTRACT
Radial neuropathies are seen in four regions along the course of the nerve: axilla level and spiral groove level neuropathies, posterior interosseous nerve and superficial radial nerve neuropathy. Although clinical findings are often sufficient and guiding in the differential diagnosis of these lesions, electrophysiological examinations are important because they provide detailed information about the clear localization of the lesion site, lesion severity and prognosis. Posterior interosseous nerve syndrome accounts for less than 0.7% of upper extremity peripheral nerve entrapment neuropathies, and since the posterior interosseous nerve is a pure motor branch, weakness is detected in the extensor carpi ulnaris and its distal finger extensors without sensory loss. Neuropathy may occur due to nerve compression in the supinator muscle, neurological amyotrophy, external pressure from space-occupying benign lesions, deformities in the elbow joint, and traumatic injury in Monteggia fractures. In this case report, it is aimed to keep partial PISS, which is encountered very rarely, in mind in the differential diagnosis of radial nerve entrapment neuropathies, and to present the diagnostic importance of electrodiagnostic examinations and treatment approaches in the light of literature information.
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