Indications Any deficits attributable to the median nerve with an associated laceration or injury along the course of the nerve, high-energy injuries associated with blunt trauma and no appreciable median nerve recovery on examination, and prior median nerve repairs with…
Indications Any deficit attributable to the ulnar nerve with an associated laceration or injury along the course of the nerve. High-energy injuries associated with blunt trauma and no appreciable recovery on examination. Prior nerve repairs with no appreciable recovery on…
Indications The major mechanisms of nerve injury include crush/compression, tension/traction, and laceration of the digits. From superficial to deep, the layers of a peripheral nerve include the epineurium, perineurium, and endoneurium. Nerve injury can occur at any or all of…
Introduction Radial neuropathy can result from direct trauma or compression anywhere along the radial nerve’s course, from the brachial plexus through the spiral groove, radial tunnel, posterior interosseous nerve (PIN), or superficial branch of the radial sensory nerve. Three types…
Introduction The ulnar nerve is a mixed motor and sensory nerve. Compression leads to a constellation of symptoms that vary depending on the location. The two most common areas of compression include the elbow (the “cubital tunnel”) and the wrist/palm…
Indications The indications for revision carpal tunnel release (CTR) include persistent, recurrent, or new symptoms after initial release. Persistent carpal tunnel syndrome Incomplete release of the transverse carpal ligament or secondary site of median nerve compression is the most common…
Indications Indications are similar to those described for open carpal tunnel release ( Chapter 55 ). Clinical examination The clinical examination is similar to that described for open carpal tunnel release ( Chapter 55 ). EXAMINATION PEARLS The wrist is…
Indications Signs and symptoms of carpal tunnel syndrome (CTS) include paresthesias, pain or numbness in the median nerve distribution (volar thumb, index, middle and radial one-half of ring finger), nocturnal neuropathic symptoms, and/or thenar muscle weakness or wasting. Carpal tunnel…
Indications Wrist denervation is indicated in patients with chronic pain but preserved motion after exhausting nonoperative treatments. Patients are candidates for denervation if they have pain from primary degenerative or inflammatory arthritis, osteonecrosis (Kienböck or Preiser disease), or traumatic conditions,…
Indications Total wrist fusion is indicated in patients with pain or instability after failure of nonoperative management and motion-preserving procedures. Wrist fusion is preferred when multiple joints (i.e., the radiocarpal and midcarpal joints) are involved. If disease is isolated to…