A rare case of delayed posterior interosseous nerve palsy that develop
ed 39 years after an unreduced anterior dislocation of the radial head
is reported. The posterior interosseous nerve was compressed and narr
owed at the arcade of Frohse. Radial head resection and release of the
arcade was done. The paralysis continued to recover 6 weeks after ope
ration. The nerve, at the arcade of Frohse, was susceptible to compres
sion by the dislocated radial head, especially in the supinated positi
on, Repeated supination and pronation movement over time may have led
to developmental changes that caused the delayed nerve palsy.