Bifid Median Nerve Complete Transection at the Wrist.

Area of Science:

• Hand surgery
• Microsurgery
• Neurology

Background:

• A 17-year-old male presented with a severe wrist laceration.
• The injury resulted in median nerve transection and loss of sensation and motor function in the hand.

Purpose of the Study:

• To describe the surgical management and outcomes of a bifid median nerve transection.
• To highlight the efficacy of microsurgical repair in restoring nerve function.

Main Methods:

• Surgical exploration under regional anesthesia with a tourniquet.
• Repair of the transected flexor digitorum superficialis tendon.
• Microsurgical repair of the bifid median nerve trunks using epineural sutures.
• Postoperative immobilization and progressive rehabilitation.

Main Results:

• Successful repair of the bifid median nerve and flexor tendon.
• Progressive recovery of sensation noted at 3 months.
• Complete nerve functional recovery, including thumb opposition, at 2.5 years.
• No thenar muscle atrophy observed.

Conclusions:

• Microsurgical repair is effective for complex median nerve injuries, including bifid nerve configurations.
• Early and complete functional recovery is achievable with appropriate surgical technique and rehabilitation.
• This case underscores the importance of meticulous surgical repair in managing sharp nerve transections.