Anterior interosseous nerve palsy complicating a forearm fracture in a child An anterior interosseous nerve palsy occurring as a complication of a closed both bone forearm fracture in a child is presented. Surgical exploration showed that a bone spike from the proximal fragment was perforating the median nerve. The fractured radius was reduced and inspection of the nerve under the microscope showed no fasicular disruption. Complete motor recovery occurred in 4 months and sensibility had fully returned at 10 months after the operation. (J HAND SURG 1990;15A:44-7.) William B. Geissler, MD, Jackson, Miss., Diego L. Fernandez, MD, Aarall, Switzerland, and Renata Graca, MD, Rio de Janeiro, Brazil We report a case of anterior interosseous nerve palsy occurring as a complication of a closed forearm fracture in a child. This lesion has been pre- viously described as a complication after forearm frac- From the Department of Tmumatology, Department of Surgery, Aarau, Switzerland. Received for publication Nov. l6, 1988; accepted in revised form Jan. 25, 1989, No benefits in any fonn have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Reprint requests: Diego L. Fernandez, MD, Chief of Traumatology, Department of Surgery, Kantonsspital Anrau, CH-500l Aarau, Switzerland. 3/l/12190 Fig. 1. Demonstrating inability to flex the left distal inter- phalangeal joint of the index finger and interphalangeal joint of the thumb while attempting to pinch. 44 THE JOURNAL OF HAND SURGERY tures in adults l and humeral supracondylar fractures in children.:!' 3 However, to our knowledge, this lesion has not been previously reported occurring after a both bones forearm fracture in a child. Anatomy The anterior interosseous nerve arises from the lateral aspect of the median nerve 5 to 8 cm distal to the lateral epicondyle. 4 It passes through a connective tissue arch formed by the deep head of the pronator teres and con- Fig. 2. Radiograph with incongruent reduction of the proximal radius with posterior medial displacement.