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Anterior interosseous syndrome is a medical condition in which damage to the anterior interosseous nerve (AIN), a distal motor and sensory branch of the median nerve, classically with severe weakness of the pincer movement of the thumb and index finger, and can cause transient pain in the wrist (the terminal, sensory branch of the AIN innervates the bones of the carpal tunnel).
Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. [2] Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. [2]
It can also occur as a result of a fall onto the thumb. This is a common injury sustained from bike falls, as the thumb is generally extended while around the handle bars. It is also a common injury in car crashes, especially into fixed objects, from the driver holding the steering wheel during impact.
When the nerve is compressed, it can result in disabling symptoms like numbness, tingling, or pain in the middle three fingers. As the condition progresses, it can lead to muscle weakness and inability to hold objects. The pain frequently occurs at night and can even radiate to the shoulder.
It is most common in the thumb and ring finger. The triggering more often occurs while gripping an object firmly or during sleep when the palm of the subject’s hand remains closed for an extended period of time, presumably because the enlargement of the tendon is maximum when the finger is not being used.
To perform the test, a patient is asked to hold an object, usually a flat object such as a piece of paper, between the thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands. [2] A normal individual will be able to maintain a hold on the object without difficulty.
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Cheiralgia paraesthetica (Wartenberg's syndrome) is a neuropathy of the hand generally caused by compression or trauma to the superficial branch of the radial nerve. [1] [2] The area affected is typically on the back or side of the hand at the base of the thumb, near the anatomical snuffbox, but may extend up the back of the thumb and index finger and across the back of the hand.