Median nerve entrapment in surgical scar: a rare complication in volar plating of fractures of distal end radius
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20232008Keywords:
Median nerve entrapment, Carpal tunnel release, Surgical scar, Distal end radius fracturesAbstract
A 25-year-old male presented to our OPD with pain and swelling of right wrist following trauma by RTA. X ray showed comminuted intraarticular fracture distal end radius (R) and confirmed with 3D CT. Patient was operated 15 days later with plate osteosynthesis using a 3-hole Elli’s T plate. The patient presented with complaints of numbness and tingling sensations over lateral 3 and half fingers about 2 months after surgery. Previous scar tissue excision was done which exposed the median nerve adhesions in its distal course with the scar tissue followed by median nerve neurolysis with carpal tunnel release was done.
References
Jakob M, Rikli DA, Regazzoni P. Fractures of the distal radius treated by internal fixation and early function: a prospective study of 73 consecutive patients. J Bone Jt Surg. 2000;82B:340-4.
Bickle K. Carpal Tunnel Syndrome. J Hand Surg. 2010;35A:147-52.
Ho AW, Ho ST, Koo SC, Wong KH. Hand numbness and carpal tunnel syndrome after volar plating of distal radius fracture. Hand (N Y). 2011;6(1):34-8.
Isobe F, Yamazaki H, Hayashi M, Uchiyama S, Miyaoka S, Kato H. Prospective Evaluation of Median Nerve Dysfunctions in Patients with a Distal Radius Fracture Treated with Volar Locking Plating. J Hand Surg Asian Pac Vol. 2019;24(4):392-9.
Seigerman D, Lutsky K, Fletcher D, Katt B, Kwok M, Mazur D et al. Complications in the Management of Distal Radius Fractures: How Do We Avoid them? Curr Rev Musculoskelet Med. 2019;12(2):204-12.
Cavalcante JBF, Cembraneli PN, Cavalcante RBF, Junior VFV, Cavalcante JEDS. Post-surgical complications of median nerve release at the wrist level. Pan Afr Med J. 2020;36:173.
Dyer G, Lozano-Calderon S, Gannon C, Baratz M, Ring D. Predictors of acute carpal tunnel syndrome associated with fracture of the distal radius. J Hand Surg. 2008;33(8):1309-13.
MacDermid JC, Wessel J. Clinical diagnosis of carpal tunnel syndrome: a systematic review. J Hand Ther. 2004;17(2):309-19.
Bentohami A, De Burlet K, De Korte N, van den Bekerom MP, Goslings JC, Schep NW. Complications following volar locking plate fixation for distal radial fractures: a systematic review. J Hand Surg Eur Vol. 2014;39(7):745-54.
Protopsaltis TS, Ruch DS. Volar approach to distal radius fractures. J Hand Surg Am. 2008;33(6):958-65.
