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CC BY-NC-ND 4.0 · J Wrist Surg 2020; 9(06): 481-486
DOI: 10.1055/s-0040-1713655
Scientific Article

Structural Changes in the Posterior Interosseous Nerve from Patients with Wrist Osteoarthritis and Asymptomatic Controls

Elin Swärd
1   Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
,
Inger Nennesmo
2   Department of Laboratory Medicine, Division of Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
,
Maria Wilcke 
1   Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
› Author Affiliations Funding This work was supported by AFA (Arbetsmarknades Försäkrings Aktiebolag) research fund. Funding for clinical research was provided at Karolinska Institutet at Södersjukhuset and Värkstadsstiftelsen.
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Abstract

Background Posttraumatic morphological changes have been described in the posterior interosseous nerve (PIN) after mild wrist trauma, and it has been suggested that posttraumatic nerve changes may contribute to wrist pain. PIN excision has shown to relieve pain in some patients with wrist osteoarthritis. However, is not known if PINs from osteoarthritic wrist have pathological features.

Objective The aim of this study was to investigate whether PINs from osteoarthritic wrists show morphological changes that are not present in healthy wrists.

Materials and Methods PINs resected from 15 osteoarthritic wrists were analyzed with light microscopy regarding morphological changes and compared with five asymptomatic controls without osteoarthritis.

Results No significant differences in fascicular area, myelinated fiber density or myelinated fiber diameter were found. However, most patients and controls exhibited some degree of pathology, and a few samples from both groups exhibited severe pathological changes.

Conclusions Our findings of morphological changes in both patients with osteoarthritis and asymptomatic controls suggest that pathological changes of unknown significance might exist in the general population in the PIN at wrist level. We believe that the observed structural nerve changes in the PIN are unlikely to contribute to the symptoms of pain. Further studies of the normal histological appearance of the terminal PIN are needed.

Level of Evidence This is Level II study.

Keywords

myelinated fiber - nerve morphology - peripheral nerve - posterior interosseous nerve - wrist osteoarthritis

Note

The work was performed at the department for Hand Surgery (Handkirurgiska kliniken) Södersjukhuset.


Ethical Approval

The study was approved by the Regional Ethic committee.




Publication History

Received: 20 March 2020

Accepted: 13 May 2020

Article published online:
29 July 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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