Isolated Compression of the Recurrent Motor Branch of the Median Nerve: A Case Report

Abstract

Isolated compression of the recurrent motor branch of the median nerve is an uncommon condition encontered in the daily life of the hand surgeon. Its early identification and correction can optimize functional outcomes. Among the few causes described, there are only 2 case reports of compression by fascial bands. We present a case of isolated compression of the recurrent motor branch of the median nerve secondary to anomalous fascial bands in a 34-year-old male patient, with significant atrophy of the thenar musculature of the right hand. Electroneuromyography showed isolated involvement of abductor pollicis brevis, with no sensory changes. The patient underwent exploration and decompression, recovering opposition and thumb function in 6 months.

Concurrent Carpal Tunnel Syndrome and Recurrent Motor Branch of the Median Nerve Compression: A Diagnostic Complexity

“…Isolated compression of the RMB of the median nerve is not common but is reported in several case reports. [1][2][3][4][5] Clinical features do not include sensory symptoms, but atrophy of the thenar musculature was involved in the descriptions. [1][2][3][4][5] In our case, the slowdown in sensory conduction velocity, prolongation in distal motor latency, and an additional reduction in compound muscle action potential amplitude in the EMG performed could easily be considered severe CTS.…”

“…[1][2][3][4][5] Clinical features do not include sensory symptoms, but atrophy of the thenar musculature was involved in the descriptions. [1][2][3][4][5] In our case, the slowdown in sensory conduction velocity, prolongation in distal motor latency, and an additional reduction in compound muscle action potential amplitude in the EMG performed could easily be considered severe CTS. Disproportionate sensory findings with atrophy of the left thenar eminence and needle EMG findings removed the diagnosis of severe CTS.…”

“…An open-label design has the disadvantage that there is a possibility of missing data because of knowledge of the assigned treatment and the expectations of those involved in the trial. 2 If the amount of missing data is large, it is not clear whether the overall trial result would have been different if the data had not been missing. 2 The open-label design also has the disadvantage that there is no randomization, no blinding, and no placebo controls.…”

“…2 If the amount of missing data is large, it is not clear whether the overall trial result would have been different if the data had not been missing. 2 The open-label design also has the disadvantage that there is no randomization, no blinding, and no placebo controls. To assess the effect of medications, it is important to conduct a completely blinded study.…”

“…RMB compression has been caused by nearby cystic masses, shiatsu massage of the hand, fascial bands, anomalous vessels, or schwannoma formation. [1][2][3][4][5] In this case report, we describe concurrent moderate CTS and RMB of the median nerve compression with a ganglion cyst.…”