The value of Presurgical Ultrasonography in Chronic Median Nerve Injury of the Palm: Case Report and Review of the Literature

Background: The prevalent approach for localizing and assessing the severity of traumatic peripheral nerve injuries involves clinical evaluation and electrodiagnostic studies. Ultrasonographic examination of the median nerve in patients with carpal tunnel syndrome (CTS) has been proposed as a useful alternative to electromyography (EMG) and nerve conduction velocity (NCV) studies in diagnosing CTS. Case presentation: A 22-year-old man developed numbness and cold intolerance over the left thumb, index and middle fingers after a penetrating injury accident to the left palm caused by a broken glass 7 years before. Primary wound closure was done at a private clinic. High-resolution ultrasonography (Philips HDI 5000 SonoCT Germany) with a 7.0-12 MHz broadband linear probe was used to evaluate the condition of the injured median nerve. Results: Ultrasonography showed complete transection of the median nerve, the presence of a neuroma and the gap in the nerve. Preoperatively, the surgical plans, such as neuroma excision and necessity for nerve grafting were explained to the patient and his family. Conclusion: Our results indicate that preoperative high-resolution ultrasonography is informative in the evaluation of chronic peripheral nerve injuries and can show the type of injury. It is also useful in the planning of surgical intervention.

並列關鍵字

ultrasonography ； median nerve injury ； old penetrating injury

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