Anterior interosseous nerve palsy following the use of elbow crutches

CONTEXT Lesions of the anterior interosseous nerve are rare and comprise less than 1% of all upper extremity nerve palsies. Traumatic causes include blunt trauma, forearm fractures, penetrating injury and local pressure from a plaster cast, but has never before been described in association with crutch use. This is the first reported case of the use of elbow crutches causing symptomatic anterior interosseous nerve compression. CASE REPORT This case describes a 30-year-old male who developed an inability to pinch with his left hand following the use of elbow crutches for a foot injury. On examination he was unable to flex the interphalangeal joint of his left thumb. A diagnosis of anterior interosseous palsy was made and the patient was treated conservatively and crutch use was ceased. At six weeks follow-up the patient made a complete recovery with full function of his left hand. CONCLUSION This report highlights the importance of adequate education in the safe use of elbow crutches for all patients. The side effects of inappropriate use should be carefully examined for during follow-up care.