Your patient describes total numbness in the tips of the index and middle fingers that has been there for 2 months.Four months ago, he sustained a Colles' fracture.While immobilized in a cast, he had experienced periods of intermittent numbness and pain.You observe atrophy in the thenar eminence and ape hand deformity.This patient most likely sustained:
A)Mild compression of the median nerve and has excellent prognosis for full recovery.
B)Laceration of the median nerve with complete interruption; there is no chance of neurological recovery.
C)Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention.
D)A stretch injury to the median nerve with adhesions preventing normal mobility; gentle nerve mobilization should alleviate the symptoms.

Question

Quizplus · Accepted Answer

The patient most likely sustained chronic compression of the median nerve, which has caused atrophy in the thenar eminence (the base of the thumb) and an ape hand deformity (inability to flex the thumb due to the weakened muscles in the thenar eminence). This suggests nerve damage that has progressed beyond the point of mild compression or stretch injury. In addition, the fact that the symptoms have persisted for 2 months and have not improved on their own indicates a guarded prognosis. Surgical intervention may be necessary to relieve the compression and restore nerve function.

Your Patient Describes Total Numbness in the Tips of the Index