title: [Median nerve neuropathy after perilunate dislocation injuries].
abstract: OBJECTIVE
  The purpose of this retrospective study was to investigate the frequency and appearance of median nerve neuropathy following perilunate dislocation injuries with respect to the preceding surgical decompression and the clinical outcome.
  
  
  METHODS
  32 patients were followed for a mean of 65 months after surgery for perilunate dislocation, including carpal tunnel release in 13 patients. 10 of 11 patients with clinical symptoms of median nerve affection at follow-up had additionally an electrophysiological examination. Median neuropathy was assumed if 2 or more parameters were pathologic. Patients with and without median neuropathy were compared. The DASH score, pain, wrist motion, grip strength and the Mayo wrist score were used to rate the outcome.
  
  
  RESULTS
  In 6 patients, neuropathy of the median nerve persisted since injury in spite of carpal tunnel release in 5 of them. 3 patients showed secondary, delayed median nerve affection. Patients with median neuropathy had a worse result with regard to pain at rest, grip force, the DASH score, and the Mayo wrist score. The difference was statistically significant for pain with activities.
  
  
  CONCLUSIONS
  Median neuropathy following perilunar dislocation injuries is frequent. It appears rather like a chronic neural lesion than a typical compression syndrome. A primary carpal tunnel release cannot always prevent persistent neural disorders.
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt a.d. Saale.
authors.forename: M
authors.initials: M
authors.lastname: Mühldorfer-Fodor
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt a.d. Saale.
authors.forename: B
authors.initials: B
authors.lastname: Hohendorff
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt a.d. Saale.
authors.forename: A A
authors.initials: AA
authors.lastname: Saalabian
authors.affiliation: Neurologische Klinik, Rhön-Klinikum, Bad Neustadt Saale.
authors.forename: M
authors.initials: M
authors.lastname: Hahne
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt a.d. Saale.
authors.forename: J
authors.initials: J
authors.lastname: van Schoonhoven
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt a.d. Saale.
authors.forename: K-J
authors.initials: KJ
authors.lastname: Prommersberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D012667:Lunate Bone / Q000293:injuries* / Q000601:surgery*; D008297:Male; D020423:Median Neuropathy / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D055815:Young Adult