Median nerve entrapment by radial fracture

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Forearm fracture 2 mths. Referred for USG - to trace median nerve to rule out compression.

Patient Data

Gender: Male

Median nerve is deviated to fracture of radius. About 25 mm length of nerve is thickened, hypoechoic without loss of continuity. Part of the nerve circumference appears to enter a radial fracture defect site.

Proximal and distal nerve segments are normal.

 

Healing fracture of forearm bones.

Photograph of surgical exploration shows abnormal coarse of nerve.

Case Discussion

Surgical exploration confirmed median nerve entrapement at fracture site. Nerve was released from bone crater and surrounding fibrosis. It was interposed between muscles. 

3 mths waiting is planned for maximum recovery.

If no or under recovery, graft is planned by plastic surgeron at present.

3 mths follow up - expected recovery was present by clinical examination.

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