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Median Nerve Injuries - Coggle Diagram
Median Nerve Injuries
Levels of injury
Elbow level
- High median nerve lesion.
- Supracondylar fracture or a dislocation of the elbow joint.
Wrist level
- knife cuts or by glass cut.
- Open injuries.
Carpal tunnel
- pressure by dislocated lunate bone and
- chronic compression by swellings in the tunnel.
Clinical Features
- Elbow: the following muscles paralysed: FCR, FDS, FDP to the middle and index fingers, FPL, PT, PQ and the thenar muscles.
- The pointing index or Oschner’s clasp test
- Inability to flex the IP of the thumb (FPL paralysis)
- Ape thumb deformity (simian hand) (paralysis of the opponens and short flexor muscles)
- Pencil test (Pen test) for abductor pollicis brevis
- Sensation: loss of sensation in the thumb, index, middle and the radial half of the ring finger.
- 1 more item...
Treatment
- Open injuries: nerve exploration and repair.
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- Irreparable lesions of the nerve at the wrist level: restoration of opponens power of the thumb by transfer of FDS tendon of the right finger to the radial side of the thumb.
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- The flexor power of thumb and index finger can also be restored by appropriate tendon transfer operation.
- Root value: C6-8, T1
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- The median nerve has a medial and a lateral head that arise from the medial and lateral cords of the brachial plexus.
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- If injury suspected, check FCR, FPL, FDS and PT