Digital nerve compression

A review of the relatively small body of literature about digital nerve compression injuries has been supplemented by the author's experience and interest of over 40 years. The principal lesions involved are of two types: (1) fibrosis about, around, and in the nerve; and (2) reactive hyperplasia of the nerve support elements and sometimes of special end organs, Pacinian corpuscles, and even of the nerve fibers themselves. Nerve signs and symptoms often accompanied by a mass in chronic cases are diagnostic. The most important features of the topic are the recognition by all of the risk elements, embodied in many personal and professional devices and techniques. These risk elements are present in all parts of our society, including home and occupational, avocational, and medical situations. Treatment is best provided by awareness of risk and avoidance of risk activities, particularly repetitive risk activities. Surgery is preferably avoided, but when indicated it is effective. It consists principally of lysis and protective positioning of the damaged nerve or, on occasion, of excision of terminal or end-organ lesions. More information must be gathered about these exceedingly common but notably under-reported problems.