Symptoms of median nerve rupture in wrist

Median nerve rupture at the wrist is a relatively serious type of injury. We know that nerve tissue is very important to human health. Once it is broken, it often causes a variety of symptoms. For example, when the median nerve at the wrist is broken, the patient will show sensory impairment, movement disorders, and obvious obstruction to the vascular motor system. At this time, it is necessary to carry out good treatment in time.

Symptoms of median nerve rupture in wrist

(1) Sensory impairment: The distribution of sensory nerves overlaps with the innervation areas of adjacent nerves, so the range of complete impairment is small and once they are damaged at the same time. The scope has also expanded. In sensory impairment, pain, touch, temperature, and stereoscopic perception are all impaired.

(2) Movement disorders: After nerve damage, the muscles it controls are completely paralyzed, and the muscles atrophy and degenerate, and the changes are progressive.

(3) No sweat: Because the sympathetic nerves running through the peripheral nerves are cut off, the sweat glands lose their function immediately and the local area gradually becomes dry. It is about the same range as sensory paralysis.

(4) Disorders of the vasomotor system: The sympathetic nerves running in the peripheral nerves have a constrictive effect on the blood vessels. Therefore, when they are cut off, they lose their vasoconstrictive effect, causing the peripheral blood vessels to dilate and become congested, the skin temperature to rise, and the skin properties to change, leading to abnormal hair and nail deformation.

(5) Nerve damage: can cause osteoporosis, joint capsule and joint fibrosis.

Disease treatment methods

Non-surgical treatment (1) Dehydration drugs relieve intracranial pressure and nerve edema. 150-200 ml of 20% mannitol is commonly used for intravenous drip, 1-2 times a day. (2) Glucocorticoid therapy protects nerves. Dexamethasone 10 mg is usually given by intravenous drip 1 to 2 times a day. (3) Drugs commonly used to dilate blood vessels and improve microcirculation include 10 mg of Nimotop, administered intravenously 1 to 2 times a day. Low molecular weight dextran 500ml intravenous drip 1 to 2 times a day. (4) Commonly used neurotrophic and metabolic drugs include energy mixture, cerebrolysin, GM1, nerve growth factor and mecobalamin. Methiconazole was administered by intravenous drip at a rate of 500 μg, 1 to 2 times a day. After 10 days, it was changed to oral administration at a rate of 0.5 mg, 3 times a day.

Surgical treatment (1) Indications for surgery: ① The fracture fragments compress the cranial nerves. ②Intracranial pressure continues to increase and cranial nerves are compressed. ③Non-surgical treatment is ineffective. ④Cause severe nerve irritation symptoms such as dizziness and neuralgia in the later stage. (2) Preoperative preparation: Determine the site of nerve damage through imaging, electrophysiology and clinical manifestations; select the nerves and muscles for transplantation. (3) Surgical methods: ① Nerve decompression, through intracranial or extracranial approach, using a drill to remove bone fragments compressing the nerve, clear the hematoma around the nerve, and cut the epineurium under a microscope, such as optic canal and facial nerve canal decompression; ② Nerve reconstruction, including: direct reconstruction, such as direct anastomosis of nerve ends and nerve transplantation anastomosis; indirect reconstruction, such as facial nerve-accessory nerve anastomosis; plastic surgery, such as corner of mouth suspension or temporalis and masseter muscle transfer for patients with facial paralysis; cranial nerve destruction, such as selective resection of the trigeminal sensory root to treat trigeminal neuralgia. (4) Postoperative treatment: Comprehensive recovery through medication, physical therapy, and acupuncture