Median Nerve Palsy

Abstract

Median nerve palsy is caused by deep, penetrating injuries to the arm, forearm, or wrist area, and occasionally from blunt force trauma or neuropathy. Injuries to the median nerve can be separated into high and low median nerve palsies, depending on the level of injury. Patients with low median nerve palsy—for example, because of a lesion at the wrist—lack the ability to abduct and oppose the thumb due to paralysis of the thenar muscles. They will also have sensory loss in the thumb, index finger, long finger, and the radial aspect of the ring finger. In contrast, patients with high median nerve palsy (lesion at the elbow and above) have weakness in forearm pronation and wrist and finger flexion, in addition to lack of thumb opposition. A variety of tendon transfers are available to restore motor function and improve functional outcome in patients with median nerve palsy.

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