A prospective plan to minimise median nerve related complications associated with operatively treated distal radius fractures.
Loss of median nerve function or a neuropathic pain syndrome may occur in around 20% of distal radius fractures if post-traumatic oedema in the carpal canal generates excessive pressure on the median nerve. No method currently exists to reliably distinguish which patients may benefit from a concomitant carpal tunnel release. This case series details the results of following a prospective plan designed to minimise median nerve related complications associated with distal radius fractures by measuring Semmes-Weinstein monofilament scores in 374 radius fracture patients who underwent surgical stabilisation. One hundred and sixty-nine patients with the clinical symptoms of median nerve compression, a decrement in monofilament score of grade 1 (out of 5) compared to the contralateral side or at least 4.31 g underwent concomitant carpal tunnel release. The remaining 205 patients did not have carpal tunnel release. There were no cases of neuropathic pain or loss of median nerve function.
Henry
Mark
M
Department of Orthopedic Surgery, Hand and Wrist Center of Houston, University of Texas Health Science Center, 1200 Binz Street, Houston, TX 77004, USA. mhenry@houstonhand.com
Stutz
Christopher
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000503:physiopathology*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000503:physiopathology / Q000517:prevention & control; D009437:Neuralgia / Q000503:physiopathology / Q000517:prevention & control; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D011885:Radius Fractures / Q000601:surgery*