Complete Transection of the Median Nerve with Distal Radius Fracture: A Case Report

We report a case of complete median nerve transection due to a distal radius fracture. In the setting of high energy trauma and a widely displaced fracture, a volar ulnar spike from the proximal fragment likely transected the median nerve. After open reduction and internal fixation of the distal radius fracture, the median nerve was repaired directly. Postoperative radiographs at 10 weeks revealed a healed fracture with clinical examination, showing good pain-free range of motion at the radiocarpal joint.

This case suggests that exploration and visualization of the median nerve to exclude injury may be considered on a case-by-case basis in the presence of sensory and motor symptoms, suggesting median nerve dysfunction after a highly displaced distal radius fracture.