[Differential treatment of post-traumatic carpal tunnel syndrome]

The pathogenesis and treatment of posttraumatic compression of the median nerve in the carpal canal are analysed in 36 patients. Nine patients had mal-union of a Colles' fracture. In these patients the symptoms of median nerve compression were completely relieved by correction osteotomy of the radial metaphysis, which also improved radiocarpal joint function. At follow-up examination after four years the results were satisfactory and the median nerve appeared normal in clinical and electro-physiological tests. In the other twenty-seven patients there had been a Colles' fracture in seventeen, healed with a deviation of less than 10 degrees; a carpal bone fracture in three cases; in seven patients no osseous lesion was found. In these patients the flexor retinaculum was split and resected. An anterior callus was removed in three cases. At reexamination after four years four patients still noticed diminished sensibility in the median nerve distribution, and in four cases there was wrist joint pain in relation to exercise.