How to treat median nerve paralysis?

summary

The median nerve is composed of neck 6-8 and chest 1. It innervates teres pronator, flexor carpi radialis, flexor digitorum, palmaris longus, palmaris pollicis opposite and abductor pollicis brevis. The main functions are forearm pronation and wrist and finger flexion. The nerve is deep and not easy to be injured. How to treat median nerve paralysis? Next, I'd like to share my views with you.

How to treat median nerve paralysis?

The wrist joint should be fixed in the middle position with splint on the palmar side. Non steroidal anti-inflammatory agents such as indomethacin and ibuprofen can be taken. In severe cases, prednisolone 0.5ml plus 2% procaine 0.5ml can be injected into the carpal tunnel once a week. If it is invalid for more than two times, and the electromyogram shows denervation of thenar muscle, surgical treatment is recommended.

Treatment of carpal tunnel: ask the patient to place the affected wrist flat on the treatment table, and place the wrist joint on the pulse pillow. There are three vertical subcutaneous protrusions on the palmar side of the wrist, the middle is the palmaris longus tendon, the radial is the radial flexor carpi, and the ulnar is the ulnar flexor carpi. At the medial edge of the flexor carpi ulnaris tendon in the distal carpal transverse stria, a needle knife entry point was set, which moved about 2.5cm to the distal end along the medial edge of the flexor carpi ulnaris muscle, and then a needle knife entry point was set; One point was fixed on the medial border of the flexor carpi radialis tendon on the transverse stripe of the distal wrist, and then moved about 2.5cm distally along the flexor carpi radialis tendon, and another point was fixed. At these four points, the knife edge line and tendon direction are parallel, and the needle body and wrist plane are 90 ° 5 cm along the medial edge of flexor tendons (avoiding ulnar, radial artery, vein and nerve), and the transverse carpal ligament was cut 2-3 mm. At the same time, push the needle knife along the medial edge of the flexor tendon to the middle for several times to peel off the adhesion between the flexor tendon and the transverse carpal ligament (to avoid damaging the median nerve), and then remove the needle.

Apply local brake. At the same time, oral administration of indomethacin, ibuprofen and other non steroidal anti-inflammatory drugs. In severe cases, prednisolone 0.5ml and 2% procaine 0.5ml can be injected into the carpal tunnel once a week. If the injection is not effective for more than two times, the electromyogram shows that thenar muscle denervation should be treated by operation.

matters needing attention

The common causes of median nerve injury are extravasation of drugs injected intravenously into the anterior cubital area, cutting of wrist by sharp instruments, fracture and perforating injury of humerus or forearm, and compression of carpal tunnel syndrome. Try to get rid of the above factors can effectively reduce or avoid the occurrence of this disease.