Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Orthopedics
Volume 2015, Article ID 703790, 3 pages
http://dx.doi.org/10.1155/2015/703790
Case Report

Magnetic Resonance Imaging Visualizes Median Nerve Entrapment due to Radius Fracture and Allows Immediate Surgical Release

1Department of Plastic and Reconstructive Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
2Department of Plastic and Reconstructive Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki 305-0005, Japan

Received 3 October 2014; Revised 16 December 2014; Accepted 17 December 2014

Academic Editor: Johannes Mayr

Copyright © 2015 Satoshi Yanagibayashi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Median nerve entrapment with forearm fracture is rare, and surgical exploration in the early stage is rarely performed. We report the case of a 19-year-old man presenting with severe pain and numbness of the thumb, index, and middle fingers and half of the ring finger along with weakness of abduction and opposition of the thumb after fracture of the radial shaft. These symptoms remained unimproved despite precise closed reduction and cast immobilization. The radius fracture was barely displaced, but complaints were increasing, particularly when the wrist and/or fingers were stretched. This suggested direct involvement of the median nerve at the fracture site, so magnetic resonance imaging (MRI) of the forearm was performed to identify any entrapment. Short tau inversion recovery MRI visualized significant deviation and entrapment of the median nerve at the fracture site. Surgical release of the entrapment was performed immediately, and complaints resolved shortly thereafter. A positive Tinel sign from the palm to the fingertips and recovery of abduction and opposition of the thumb were seen at 6 months postoperatively. This report highlights the utility of MRI for detecting median nerve entrapment at a fracture site, allowing immediate surgical release.