Institut Universitaire Locomoteur et du Sport (IULS), Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hôpital Pasteur 2, Nice, France.
Institut Universitaire Locomoteur et du Sport (IULS), Service de Chirurgie Réparatrice et de la Main, CHU de Nice, Hôpital Pasteur 2, Nice, France; Laboratoire d'Anatomie humaine, Faculté de Médecine de Nice, Université Côte d'Azur, Nice, France.
Ann Chir Plast Esthet. 2021 Apr;66(2):180-183. doi: 10.1016/j.anplas.2020.07.006. Epub 2020 Aug 3.
Posttraumatic acute carpal tunnel syndrome is a not a usual complication in traumatic hand injuries but requires more urgent and aggressive management. Compression of the median nerve should be systematically sought when there is a major and painful swelling of the hand, associated with one or several hand and wrist fractures. In rare case, a single metacarpal fracture or dislocation can be the only cause of median nerve compression and requires urgent diagnosis. If missed or neglected irreversible damage could occur to the median nerve. If surgery is perform in a timely manner outcomes are excellent, with complete recovery in most of the cases. We present the case of a 24-year-old man with an acute compression of the median nerve due to an intra-articular fracture of the 2nd metacarpal base. A bony fragment shifting from the base of 2nd metacarpal was found in the carpal tunnel participating, at least in part, in the compression of the median nerve.
创伤性急性腕管综合征并非创伤性手部损伤的常见并发症,但需要更紧急和积极的治疗。当手部出现严重且疼痛性肿胀,伴发一处或多处手部和腕部骨折时,应系统寻找正中神经受压的情况。在极少数情况下,单一掌骨骨折或脱位也可能是正中神经受压的唯一原因,需要紧急诊断。如果漏诊或忽视,正中神经可能会发生不可逆转的损伤。如果及时进行手术,大多数情况下的治疗效果非常好,可完全恢复。我们报告了一例 24 岁男性患者,因第 2 掌骨基底关节内骨折导致正中神经急性受压。在腕管内发现一块从第 2 掌骨基底移位的骨碎片,至少部分参与了正中神经的受压。