Houston Methodist. Leading Medicine

Hand FAQ


I'm agonizing over a decision about whether or not to have surgery for my hand. I work as a transcriptionist and typing has become increasingly difficult. The orthopedic hand surgeon I saw thinks I have a nerve palsy (of the AIN nerve, if I understood it all correctly). Would having surgery to release the nerve speed up recovery? I need to be able to type 150+ words per minute and right now I'm at 40.


It sounds like you may have a condition called anterior interosseous nerve palsy AIN stands for anterior interosseous nerve. It is the nerve that supplies the muscles of the hand/fingers (flexor pollicis longus and flexor digitorum profundus) that make it possible to form the "OK" sign with the thumb and index finger. Considering how often we use the thumbs to hit the space bar, loss of anterior interosseous nerve function can be very disabling for someone making a living at the keyboard. The same is true for those who hunt and peck with just the index fingers. But if you are typing 150 (or more) words per minute, you probably are most likely using both hands together at the same time. Research shows that spontaneous recovery is the norm for anterior interosseous nerve palsy. But healing takes time. Initial signs of recovery may be seen as early as six months after the first symptom appeared. The average time is closer to 12 months. And for those who are over 40, the expected time for full recovery is 18 months. According to a recent review study on this topic, surgery is not recommended unless there is complete loss of nerve transmission due to some type of trauma, infection, or tumor. Patients should be followed carefully and monitored for recovery. Some patients are advised to take Vitamin B12 to help enhance nerve function. Electrical stimulation therapy provided by a hand therapist may be of some benefit. Electrodiagnostic testing can be done to look for signs of recovery and then repeated every four to six weeks to observe the progression of improvement in nerve function. Ying Chi, MD, and Neil G. Harness, MD. Anterior Interosseous Nerve Syndrome. In The Journal of Hand Surgery. December 2010. Vol. 35. No. 12. Pp. 2078-2081.

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