Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature

Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Series: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2x3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms

[1]  A. Aslan,et al.  Post-traumatic Median Nerve Neuroma in Wrist. A Case Report and brief review of Literature , 2013, Journal of Orthopaedic Case Reports.

[2]  Julien Hubert,et al.  Schwannoma of the median nerve , 2013, Journal of plastic surgery and hand surgery.

[3]  K. Ikeda,et al.  Ossified median nerve schwannoma: a case report. , 2012, Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand.

[4]  A. Saifuddin,et al.  Indeterminate soft-tissue tumors of the hand and wrist: a review based on a clinical series of 39 cases , 2011, Skeletal Radiology.

[5]  D. Netscher,et al.  Management of distal traumatic median nerve painful neuromas and of recurrent carpal tunnel syndrome: hypothenar fat pad flap. , 2010, The Journal of hand surgery.

[6]  A. E. Bagatur,et al.  Unilateral carpal tunnel syndrome caused by an occult palmar lipoma. , 2009, Orthopedics.

[7]  Kamfai Lee,et al.  The Role of High-Resolution Ultrasound in the Diagnosis of a Traumatic Neuroma in an Injured Median Nerve , 2009, American journal of physical medicine & rehabilitation.

[8]  E. Coşkunol,et al.  Schwannomas of the Hand and Wrist: Long-Term Results and Review of the Literature , 2005, Journal of orthopaedic surgery.

[9]  L. Robinson traumatic injury to peripheral nerves. , 2005, Supplements to Clinical neurophysiology.

[10]  S. Mackinnon,et al.  Nerve repair, grafting, and nerve transfers. , 2003, Clinics in plastic surgery.

[11]  Steven Lee,et al.  Tumorlike Lesions and Benign Tumors of the Hand and Wrist , 2003, The Journal of the American Academy of Orthopaedic Surgeons.

[12]  Sang-Jin Shin,et al.  Schwannomas of the Upper Extremity , 2000, Journal of hand surgery.

[13]  C. Lavernia,et al.  Anatomy and physiology of peripheral nerve injury and repair. , 2000, American journal of orthopedics.

[14]  E. Alexander Nerve injuries and their repair — A critical appraisal , 1992 .

[15]  W. Wong,et al.  An unusual case of neuroma of the median nerve. , 1969, Journal of neurology, neurosurgery, and psychiatry.

[16]  H. Seddon Classification of Nerve Injuries , 1942, British medical journal.