Document Detail


A case of anterior interosseous nerve syndrome after peripherally inserted central catheter (PICC) line insertion.
MedLine Citation:
PMID:  14770261     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Palsies involving the anterior interosseous nerve comprise less than 1% of all upper extremity nerve palsies. Patients often present initially with acute pain in the proximal forearm, lasting several hours to days. The pain subsides, to be followed by paresis or total paralysis of the pronator quadratus, flexor pollicis longus and the radial half of the flexor profundus, either individually or together. Patients with a complete lesion will have a characteristic pinch deformity. We report a case of anterior interosseous syndrome in a 42-year-old male. The patient was admitted initially for chronic osteomyelitis of the left calcaneum. He had a peripherally inserted central catheter (PICC) line inserted into a brachial vein for the administration of intravenous antibiotics, and developed anterior interosseous nerve palsy as a complication of this procedure. The catheter was subsequently removed and a new line was placed on the other side, and his neurological deficit has been improving since. This case highlights the potential hazards of venupuncture or arterial puncture of the brachial vein or artery respectively, even under controlled conditions with the benefit of ultrasound guidance. It also serves as a reminder to look out for the complications of these common procedures, and to be able to react appropriately when they arise.
Authors:
M E Puhaindran; H P Wong
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Singapore medical journal     Volume:  44     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-10     Completed Date:  2004-04-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  Singapore    
Other Details:
Languages:  eng     Pagination:  653-5     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. Ho_Poh_Wong@ttsh.com.sg
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheterization, Central Venous / adverse effects*
Catheterization, Peripheral / adverse effects*
Humans
Male
Median Nerve
Nerve Compression Syndromes / etiology*
Osteomyelitis / complications,  therapy
Pain / etiology
Paralysis / etiology
Paraplegia / complications
Phlebotomy / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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