Median Nerve Entrapment Syndrome Due to Adhesion of Laceration Wound by Suicidal Attempt -A Case Report.

Baek, In Soo; Roh, Sang Hoon; Sohn, Hyung Bin; Hong, In Pyo

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(5):676-680.
Published online September 1, 2010.

Median Nerve Entrapment Syndrome Due to Adhesion of Laceration Wound by Suicidal Attempt -A Case Report.

In Soo Baek, Sang Hoon Roh, Hyung Bin Sohn, In Pyo Hong

Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea. nmcps@unitel.co.kr

Abstract

PURPOSE
Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. METHODS: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve.
RESULTS
The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year.
CONCLUSION
We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.

Keywords: Carpal tunnel syndrome; Median nerve; Laceration