Open fracture of the distal radius with complete laceration of the median nerve.

Abstract

Introduction: median nerve neuropathy accompanying a distal radius fracture is common. Differential diagnosis includes nerve contusion, acute carpal tunnel syndrome, forearm compartment syndrome or exacerbation of an idiopathic carpal tunnel syndrome.

Case report: a 44-year-old male presented with a right distal radius fracture after a motorcycle accident. He presented a 1.3 cm blunt wound situated proximal to the radiocarpal flexion crease and complained of well-defined numbness in the median nerve territory. The fracture was reduced and fixed using a volar plate and the median nerve was explored finding a complete section with a 2.0 cm defect. The carpal tunnel was released and a sural nerve fascicular graft was interposed presenting good results at final follow-up.

Conclusion: a median nerve transection after a radius fracture is an exceedingly rare injury. This case report emphasizes the importance of an accurate physical examination including the initial neurological assessment.