Chronic dorsal wrist pain limits hand function and is related to several diseases. Especially, pain and tenderness over the fourth extensor compartment with repetitive wrist dorsiflexion was described as distal posterior interosseous nerve syndrome. This article details the history, symptoms, physical findings, and treatment of this syndrome.

This study includes six patients seen between 1996 and 1998. Five men and one woman (ages 17 to 57 years) presented with localized, nonradiating, dull dorsal wrist pain, ulnar and distal to Lister's tubercle. Presumptive diagnostic test was an injection of selective lido cane 2 cm proximal to the wrist joint.

Six patients were diagnosed of having distal posterior interosseous nerve syndrome. The five patients who recurred symptoms after injection underwent surgical exploration. Histologic evaluations revealed abnormal perineural fibrosis and edema. Patients were reexamined at least 12 months after surgery and have returned to full asymptomatic activity.

Initially, non-operative treatment seems to be effective. If conservative treatment fails, operative excision of distal posterior interosseous nerve may be required