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Median Nerve Entrapment Syndrome Due to Adhesion of Laceration Wound by Suicidal Attempt -A Case Report  

Baek, In-Soo (Department of Plastic and Reconstructive Surgery, National Medical Center)
Roh, Sang-Hoon (Department of Plastic and Reconstructive Surgery, National Medical Center)
Sohn, Hyung-Bin (Department of Plastic and Reconstructive Surgery, National Medical Center)
Hong, In-Pyo (Department of Plastic and Reconstructive Surgery, National Medical Center)
Publication Information
Archives of Plastic Surgery / v.37, no.5, 2010 , pp. 676-680 More about this Journal
Abstract
Purpose: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. Methods: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. Results: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. Conclusion: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.
Keywords
Carpal tunnel syndrome; Median nerve; Laceration;
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1 Loos MJ, Scheltinga MR, Roumen RM: Surgical management of inguinal neuralgia after a low transverse Pfannenstiel incision. Ann Surg 248: 880, 2008   DOI   ScienceOn
2 A. Lee DELLON, MD: Nerve entrapment syndromes. In Mathes SJ, Henz VR (eds): Plastic Surgery. 2nd ed, Philadelphia, Saunders, 2006, p 875
3 Lee DH, Masear VR, Meyer RD, Steven DM, Colgin S: Endoscopic carpal tunnel release: a cadeveric study. J Hand Surg Am 17: 1003, 1992   DOI   ScienceOn
4 Ho Jung Kang, MD, Si Young Park, MD, Sang Jin Shin, MD, Eung Shick kang, MD, Soo Bong Hahn, MD: Tuberculosis tenosynovitis presenting as carpal tunnel syndrome. J Korean Soc Surg Hand 5: 137, 2000
5 Ettema AM, Amadio PC, Zhao C, Wold LE, O'Byrne mm, Moran SL, An KN: Changes in the functional structure of the tenosynovium in idiopathic carpal tunnel syndrome: a scanning electron microscope study. Plast Reconstr Surg 118: 1413, 2006   DOI   ScienceOn
6 Yoon JO, Kim EG, Lee KW, Kim SM: Detection of synovial hypertrophy in idiopathic carpal tunnel syndrome using ultrasonography. J Korean Orthop Assoc 35: 499, 2000
7 Moon ES, Rowe SM, Cho ST, Seon KJ: Nerve conduction studies after surgical release of carpal tunnel syndrome. J Korean Orthop Assoc 31: 270, 1996
8 Low HL, Sivasamy VP, Griffiths AP, Redfern RM: Recurrent carpal tunnel syndrome caused by space occupying lesions. Neurosurgery 60: E956, 2007   DOI
9 Rodrigues RL, Shin AY: Treatment options for recurrent carpal tunnel syndrome: local flaps. Tech Orthop 21: 61, 2006   DOI   ScienceOn
10 Loundborg G: Intraneural microcirculation. Orthop Clin NA 19: 1, 1988
11 Wulle C: The synovial flap as treatment of the recurrent carpal tunnel syndrome. Hand Clin 12: 379, 1996
12 Mass DP, Tuel R: Human flexor tendon participation in the in vitro repair process. J Hand Surg Am 14: 64, 1989   DOI   ScienceOn
13 Lehfeldt M, Ray E, Sherman R: Moc-ps (sm) cme article: treatment of flexor tendon laceration. Plast Reconstr Surg 121: 1, 2008
14 Cetin A, Dinçer F, Keçik A, Cetin M: Rehabiliation of flexor tendon injuries by use of a combined regimen of modified Kleinert and modified Duran techniques. Am J Phys Med Rehabil 80: 721, 2001   DOI   ScienceOn