Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Florida Health, Gainesville, Florida.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0328. doi: 10.2106/JBJS.CC.19.00328.
We report a case of complete median nerve transection due to a distal radius fracture. In the setting of high energy trauma and a widely displaced fracture, a volar ulnar spike from the proximal fragment likely transected the median nerve. After open reduction and internal fixation of the distal radius fracture, the median nerve was repaired directly. Postoperative radiographs at 10 weeks revealed a healed fracture with clinical examination, showing good pain-free range of motion at the radiocarpal joint.
This case suggests that exploration and visualization of the median nerve to exclude injury may be considered on a case-by-case basis in the presence of sensory and motor symptoms, suggesting median nerve dysfunction after a highly displaced distal radius fracture.
我们报告了一例因桡骨远端骨折导致正中神经完全断裂的病例。在高能量创伤和广泛移位骨折的情况下，来自近端骨块的掌侧尺骨突可能会切断正中神经。在对桡骨远端骨折进行切开复位内固定后，直接修复正中神经。术后 10 周的 X 线片显示骨折愈合，临床检查显示桡腕关节活动度良好，无痛。
本病例提示，在高度移位的桡骨远端骨折后出现感觉和运动症状、提示正中神经功能障碍的情况下，可根据具体情况考虑探查并可视化正中神经以排除损伤。
