Median Nerve Injury

Median nerve injury

Median nerve injury is Injury to the median nerve at the elbow. It may cause symptoms to appear in the forearm, wrist, and hand. They are often caused by another sudden injury which traps or tears the nerve.

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Symptoms of a median nerve injury

Symptoms of a median nerve injury consist of:

  • Weakness gripping things
  • Inability to move your thumb across your palm
  • Muscle wasting at the base of the thumb

In addition, depending on whether your injury is above the elbow or below:

  • Above the elbow results in difficulty turning the hand over or flexing the wrist down
  • Below the elbow causes tingling or numbness in the forearm, thumb and the three adjacent fingers

What is a Median nerve injury?

A median nerve injury is any injury to the median nerve. It can be torn partially, fully or compressed at the elbow.

Anatomy

The median nerve emerges from the neck at the brachial plexus, between the 5th cervical and 1st Thoracic vertebrae. It passes down the arm, past the elbow and splits into branches. The branches serve the thumb and three fingers (missing just a little, pinky finger!).

At the elbow, the nerve passes to the inner side of the joint. Therefore, injuries in this area often cause median nerve pain.

It also runs alongside the brachial artery. An acute injury to the median nerve here may also cause injury to this major blood vessel.

Causes

Median nerve injuries result from fractures or other traumatic injury. Or compression from excess fluid build up following injury.

Your doctor examines injuries such as a supracondylar fracture, elbow dislocation or any form of fracture for median nerve damage.

Even relatively minor injuries, to the medial ligament, for example, may result in median nerve symptoms due to increased pressure on the nerve from bleeding and swelling in the area.

Types of median nerve injury

Median nerve injury at the elbow is either a lesion (tear) or a compression injury.

Lesions are more serious, long-term injuries. This is because nerves take a long time to re-grow. Swelling resulting from fractures often cause compression nerve injuries. These usually resolve when the swelling goes down.

Carpal tunnel syndrome

The most common injury involving the median nerve is Carpal Tunnel Syndrome. However, this is caused by a decrease in space at the carpal tunnel in the wrist and so would not occur as a result of an elbow injury.

Pronator teres syndrome

Pronator Teres Syndrome is another entrapment neuropathy of the median nerve, this time as it passes between the two heads of the pronator teres muscle.

Treatment

If it is caused by another acute injury, the priority is to treat the initial injury. This may be a fracture or dislocation or a soft tissue injury. But in many cases, treating the offending injury eases the median nerve symptoms.

Applying ice, compression, and elevation reduces pain and swelling. As a result, pressure on the median nerve reduces.

A displaced fracture at the elbow, must be corrected with surgery. The surgeon removes or realigns the fragment, easing pressure on the nerve.

Median nerve symptoms clear up quickly if there is no long-term damage. However, symptoms last longer if there is nerve damage.

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