An unusual complication of percutaneous fixation of a schapoid fracture in a 36-year-old man is described. After this surgery, the patient complained of numbness and tingling within the median nerve distribution and thenar weakness. An Electromyography showing moderate CTS had led to carpal tunnel decompression, which resulted unsuccessful. When the patient presented to us, both sensory and motor median nerve impairment were present, interfering with his professional activity. A computed tomography scan performed to assess the scaphoid screw position, showed that the screw had been placed volar to the scaphoid, adjacent to the median nerve. Surgery confirmed median nerve compression by the screw, especially during complete wrist extension. The surgical removal of the screw led to immediate improvement of both the motor and sensory functions of the nerve, with complete clinical restoration of nerve function and resolution of the symptoms 2 months postoperatively.
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http://dx.doi.org/10.1097/GOX.0000000000002292 | DOI Listing |
J Hand Surg Am
January 2025
Musculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Carpal tunnel syndrome (CTS) is the most common compression neuropathy. The median nerve contains sensory, motor, and sympathetic fibers. Involvement of the different fibers of the median nerve in CTS may vary; hence, one of the sensory, motor, or autonomic dysfunctions may be dominant.
View Article and Find Full Text PDFJ Hand Surg Am
January 2025
Department of Neurosurgery, Nossa Senhora da Conceição Hospital, Tubarão, Brazil.
Purpose: Brachial plexus traction injuries have conventionally been categorized as involving the C5-C6, C5-C7, C5-T1, and C8-T1 roots. In this article, we report a distinct clinical presentation of brachial plexus injury characterized by intact finger flexion with signs of complete brachial plexus injury.
Methods: From 2010 to 2022, 989 patients who sustained brachial plexus injuries were examined and underwent surgery.
Medicina (Kaunas)
December 2024
Department of Surgery, Riga East Clinical University Hospital, 1038 Riga, Latvia.
Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Adults' Infectious Diseases, Medical University of Warsaw, 01-201 Warsaw, Poland.
: The aim of this study was to evaluate the association between various clinical and laboratory findings and in-hospital mortality in community-acquired bacterial meningitis (BM). : We retrospectively analyzed 339 adult (≥18 years old) patients with bacterial meningitis who were admitted to the Hospital for Infectious Diseases in Warsaw between January 2010 and December 2017. : Altogether, 56 patients (16.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
PhysiUZerapy: Health Sciences Research Group, University of Zaragoza, Calle Domingo Miral S/N, 50009 Zaragoza, Spain.
Background: When performing the Upper Limb Neurodynamic Test 1 (ULNT1), the order of joint movement can be varied to place more stress onto certain nerve segments. However, the mechanisms underlying this phenomenon are still unclear. This study aimed to analyze the differences in the stiffness of the median nerve (MN) and the brachial plexus (BP) using ultrasound shear wave elastography during three sequences of the ULNT1: standard (ULNT1-STD), distal-to-proximal (ULNT1-DIST), and proximal-to-distal (ULNT1-PROX).
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