IS THE DORSAL APPROACH TO THE ANTERIOR INTEROSSEOUS NERVEDURING THE PARTIAL WRIST DENERVATION SAFE

Partial wrist denervation is a palliative procedure for chronic wrist pain that should provide many of the benefits of total wrist denervation with negligible morbidity. The procedure consists in isolated anterior and posterior interosseous neurectomies performed through a single dorsal incision. The anterior interosseous nerve (AIN) is resected when it runs between the interosseous membrane and pronator quadratus muscle (PQM). Most of the branches of the distal part of the AIN enter the pronator quadratus muscle. We do not recommend division of the AIN from the dorsal approach through the interosseous membrane because of possible injury of the AIN muscular branches. Such type of wrist denervation would risk damage of the innervation of the PQM that is of great importance for initiation of hand pronation.