Median Nerve Injury

Median Nerve Injury
July 14, 2016

carpal-tunnel-syndrome180As a renowned orthopedics for past 25 years and having successfully performed more than 6000 complicated surgeries in the hand and upper extremity region Dr. Gupta considers, “When injury or any traumatic condition to the median nerve at the elbow causes impairment in the arm, elbow or wrist and results in a movement loss, it usually becomes essential to relieve the compressed nerve by either surgery or tendon transfer to stop further debilitation of the nerve.”

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With his experience in Fortis, AIIMS, Medanta and presently placed as the head of hand and shoulder division, Max Healthcare, Dr Gupta is perhaps one of the most efficient orthopedic surgeons in India. Stressing on the causes and prevalent signs he says, “if the median nerve gets damaged the hand becomes prone to dropping the objects easily and not being able to grasp things as the thumb and fingers become weak. There is a burning pain and tingling which makes it difficult for the patient to sleep comfortably at night. As regarding why the median nerve gets compressed I would say previous fracture, injury, traumatic fall, conditions like arthritis, tendonitis can result in Median nerve palsy.”

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Having operated upon many complex tumors, fractures, arthritis, nerve injuries Dr. Gupta emphasizes, “We usually conduct a pen test or Benediction test to confirm the presence of median nerve injury and then with the help of x-ray we conclusively determine the severity of the injury. Conservative techniques are our beginning tools which may be extended to surgical release of the nerve if the patient is not relieved of the enervating pain.”

 

FAQ – Median Nerve Injury

Partial or complete tear or compression of the Median Nerve at the elbow is referred to as a Median Nerve Injury. In simple terms it is an injury to the nerve above the elbow which causes limitations in hand or wrist mobility.
Median nerve is the nerve that starts from the neck at the brachial plexus, passes through the arm, the elbow and ends as branches into the thumb and the first three fingers.
Causes of Median Nerve injury or palsy can be caused due to traumatic injury to the elbow or fracture or injury in the wrist(Carpal Tunnel Syndrome). Entrapment of the nerve due to any reason can result in median nerve injury. In some cases the nerve may also get compressed at the wrist by arthritis, tendonitis or any such conditions that affect connective tissues.
The most prevalent signs that indicate the presence of median nerve injury are: Changes in the sensation of the thumb and first two fingers, intense and burning pain in the wrist or hand, more so at night, weakness in the hand resulting in dropping of objects and difficulty in grasping things.
After physical examination the doctor conducts a pen test, Oschners clasp test or Benediction test to further deduce and confirm that it is the median nerve that has been affected.
Depending on the severity, the treatment technique either comprises of conservative or surgical methods.
Conservative Techniques: Oral anti inflammatory medicines, corticosteroid injections, physical therapy exercises, braces/splints to immobilize the elbow and wrist along with avoidance of activities that put pressure on the nerve are some conservative techniques that are worked upon to relieve the patient. If the patient is not relieved of the symptoms within 2 to 3 months then surgical release becomes essential.
Surgical Techniques: It involves removing the part of bones that are compressing the nerve, excising the tissue or transfer of tendon.
Complete recovery in severe median nerve palsy may vary from months to a few years. With the arm and elbow flexed at 90 degree, therapy exercises applied to enable restoration in movement and not using the muscles to avoid re injury are important to heal after the surgery.
Posted in Condition & Treatments by admin