[Acute carpal tunnel syndrome secondary to prolonged pressure on the wrist during enolic coma].
We report a case of acute carpal tunnel syndrome caused by prolonged compression. A 40-year-old man was admitted for an acute carpal tunnel syndrome secondary to direct compression of the wrist which was blocked in supination under his thorax for ten hours during a period of alcoholic coma. Total sensorial anesthesia of the median nerve territory was noted. The emergency procedure consisted in simple opening of the carpal tunnel without nerve exploration due to the risk of bacterial contamination resulting from skin lesions, devascularization and postoperative fibrosis. Initially, the skin on the volar aspect of the wrist had the aspect of a second degree burn. The patient recovered nerve function the next day and the skin wound healed within 15 days. The patient was seen at consultation at 13 months and exhibited complete recovery of wrist and hand motion with normal thumb opposition and no signs of sensorial or motor deficit. The retinaculum of the flexor system must be opened to guarantee full nervous recovery.
Uzel
A-P
AP
Service d'orthopédie et traumatologie, CHU de Pointe-à-Pitre, route de Chauvel, 97159 Pointe-à-Pitre cedex, Guadeloupe. maxuzel@hotmail.com
Vogels
J
J
Massicot
R
R
Lemonne
F
F
D000208:Acute Disease; D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications*; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D003128:Coma / Q000139:chemically induced / Q000150:complications; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome