pathology: supinator ligament syndrome / supinator tunnel syndrome / supinator syndrome / posterior interosseous nerve syndrome / Frohse syndrome / posterior interosseous nerve syndrome

yogabook / pathology / supinatorenlogensyndrom

Definition

Supinator lodge syndrome is a usually painless nerve compression syndrome of the posterior interosseous nerve, a purely motor branch of the ramus produndus of the radial nerve. radialis, by the supinator, which affects the extensor digitorum through compression, but not the extensor carpi radialis, so that the extension of fingers 2-5, especially 3 and 4, is impaired, but not the dorsiflexion of the wrist. The ramus produndus runs in the Frohse arcade between the profound (origin at the medial epicondyle of the humerus) and superficial part (broad origin at the palmar ulna) of the supinator, so that its hypertrophy can lead to compression of the nerve.

In contrast to supinator ligament syndrome, radial tunnel syndrome shows no motor deficits but significant pain. In radial tunnel syndrome, there are also various possible sites with triggering compression.

Cause

  1. Dislocations of the radial head
  2. fractures of the radial head, fractures of the ulna
  3. Direct injuries to the nerve
  4. Contusion with formation of a haematoma
  5. Hypertrophy of the supinator or pronator teres due to corresponding demand on the muscle
  6. iatrogenic: such as paravenous injections
  7. Pressure on the nerves due to lipomas, ganglia
  8. Compression of the Frohse arcade (fibrous entry area of the posterior interosseous nerve between the profound and superficial part of the supinator)
  9. Prolonged powerful pronation, which increases the tension of the supinator

Diagnosis

  1. The diagnosis is usually made clinically
  2. EMG, nerve conduction velocity
  3. Imaging to rule out other causes of compression
  4. Wrist dorsiflexion is weakened with a tendency to radial abduction

Symptoms

  1. Progressive paralysis of the finger extensors, especially fingers 3 and 4 without paralysis of the extensor carpi radialis.
  2. Normally painless course, at best dull rest pain and thorax pain
  3. possibly paresis of the supinator

DD

  1. Lipoma under the supinator

Therapy

  1. Therapy trial with analgesics (if necessary), physiotherapy, strengthening training, stretching training and rest
  2. Surgery: decompression surgery, the success of therapy is usually only apparent after weeks to months

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