J Korean Orthop Assoc JKOA Journal of the Korean Orthopaedic Association 1226-2102 2005-8918 The Korean Orthopaedic Association 10.4055/jkoa.2011.46.1.78 Case Report Incomplete Anterior Interosseous Nerve Palsy That Accompanied a Monteggia Fracture Yang Bo-Kyu M.D. Kim Seong-Wan M.D. Yi Seung-Rim M.D. Ahn Young-Jun M.D. Noh Jung-Ho M.D. Roh Young-Hak M.D. Lee Seung-Won M.D. Je Min-Soo M.D. Kim Seok-Jin M.D. Department of Orthopedic Surgery, National Police Hospital, Seoul, Korea. Correspondence to: Seong-Wan Kim, M.D. Department of Orthopedic Surgery, National Police Hospital, 58, Garak-dong, Songpa-gu, Seoul 138-708, Korea. TEL: +82-2-3400-1333, FAX: +82-2-449-2120, swkim@nph.go.kr 02 2011 22 02 2011 46 1 78 81 29 12 2009 16 08 2010 Copyright © 2011 by The Korean Orthopaedic Association 2011

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The anterior interosseous nerve innervates the flexor pollicis longus, the flexor digitorum profundus and the pronator quadratus. There are no sensory fibers from the anterior interosseous nerve leading to the skin. Paralysis of the anterior interosseous nerve that accompanies a Monteggia fracture has rarely been reported, and incomplete paralysis of the anterior interosseous nerve has almost not been reported. We experienced a patient with incomplete anterior interosseous nerve palsy involving the flexor pollicis longus as a complication of a Monteggia fracture. The paralysis of the flexor pollicis longus recovered 4 months after the surgery for the Monteggia fracture.

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Initial photogragh shows limitation of thumb interphalangeal flexion with intact distal interphalangeal joint flexion of index finger.

Preoperative simple radiographs of left forearm show anterior angulation of proximal ulna fracture and dislocation of radial head.

Flexor pollicis longus integrity test suggested by Mody and Melton shows no evidence of the injury of flexor pollicis longus.

Postoperative simple radiographs of left forearm show internal fixation of proximal ulna shaft fracture with reduction of radial head.

Normal flexion of thumb interphalangeal joint is restored at postoperative 3 months.