The Isolated Motor Branch of the Ulnar Nerve Injury During Open Carpal Tunnel Release

Siriwittayakorn, Wuttipong; Fongsri, Warangkana; Watatham, Kraisong; Atthakorn, Wattanai

doi:10.7759/cureus.43601

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Cureus

2023

DOI: 10.7759/cureus.43601

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The Isolated Motor Branch of the Ulnar Nerve Injury During Open Carpal Tunnel Release

Wuttipong Siriwittayakorn,

Warangkana Fongsri,

Kraisong Watatham

et al.

Abstract: A 76-year-old woman underwent open carpal tunnel release (OCTR). She had sudden sharp shooting pain in her hand, in the mid-palmar area, during the operation. She was then unable to abduct or adduct her thumb and fingers after surgery. She had no sensation impairment of the ulnar digit. The nerve conduction study confirmed a complete transection of the motor branch of the ulnar nerve (MUN). The MUN was repaired, and the patient recovered her intrinsic hand muscle function two years after the operation. The mec… Show more

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2024

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Cited by 1 publication

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Unusual Motor Hand Neuropathies: Causes, Diagnosis, and Evaluation of Motor Impairments

Khodulev,

Klimko,

Pereverzeva

et al. 2024

Cureus

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BackgroundIsolated hand motor nerve injuries, specifically those affecting the recurrent motor branch of the median nerve and the deep motor branch of the ulnar nerve, are rarely reported in medical literature. Diagnosing and quantifying these injuries pose significant challenges due to their uncommon nature and the variety of mechanisms that can cause them. MethodologyThis study reviews six unusual cases of isolated damage to the recurrent motor branch of the median nerve and the deep motor branch of the ulnar nerve, including cases with combined injuries. The etiologies include various traumatic and compressive mechanisms, such as a blow from the thenar to the back of a knife blade, long-distance cycling, impact from a broken shovel handle, knife injury, and damage from a screw while using a cordless screwdriver. In one case, the cause was indeterminate. Diagnostic methods involved clinical evaluation, electrophysiological testing (nerve conduction studies and electromyography), and highresolution ultrasound imaging. A thorough medical history was also crucial in understanding the injury mechanisms. ResultsThe cases demonstrated a range of causes for isolated hand motor nerve injuries, with both traumatic and compressive mechanisms identified. The diagnostic process highlighted the value of integrating clinical assessments, electrophysiological data, and ultrasound imaging to accurately diagnose and understand the extent and nature of the injuries. ConclusionsIsolated motor nerve injuries in the hand can arise from diverse and often unexpected causes. Comprehensive clinical evaluation, supported by electrophysiological testing and ultrasound imaging, is essential for accurate diagnosis and management. A detailed medical history is invaluable in identifying the mechanism of injury, which is critical for developing an appropriate treatment plan. The study underscores the importance of a multidisciplinary approach in diagnosing and treating these rare neuropathies.

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Unusual Motor Hand Neuropathies: Causes, Diagnosis, and Evaluation of Motor Impairments

Khodulev,

Klimko,

Pereverzeva

et al. 2024

Cureus

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show abstract

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The Isolated Motor Branch of the Ulnar Nerve Injury During Open Carpal Tunnel Release

Cited by 1 publication

References 14 publications

Unusual Motor Hand Neuropathies: Causes, Diagnosis, and Evaluation of Motor Impairments

Unusual Motor Hand Neuropathies: Causes, Diagnosis, and Evaluation of Motor Impairments

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