Peripheral nerve entrapment caused by motor vehicle crashes

Area of Science:

• Orthopedics
• Neurology
• Traumatology

Background:

• Motor vehicle collisions (MVCs) historically led to severe injuries before modern safety features.
• Upper extremity peripheral nerve problems, excluding brachial plexus injuries, have not been definitively linked to MVCs.
• Nerve entrapment syndromes are common, but their association with MVCs requires further investigation.

Purpose of the Study:

• To investigate the causal relationship between motor vehicle collisions (MVCs) and upper extremity nerve entrapments.
• To identify the incidence and patterns of carpal tunnel syndrome (CTS), cubital tunnel syndrome (CT), and radial sensory nerve (RSN) entrapments following MVCs.
• To propose a pathomechanism for MVC-induced upper extremity nerve compression.

Main Methods:

• Retrospective review of 725 patients diagnosed with CTS, CT, or RSN entrapment.
• Analysis of patient data to identify cases causally linked to MVCs.
• Examination of injury patterns, including laterality and common collision dynamics.

Main Results:

• 157 out of 725 patients (21.7%) had MVC-related nerve entrapments.
• Carpal tunnel syndrome (CTS) was the most frequent (68 cases), followed by cubital tunnel syndrome (CT) (64 cases) and radial sensory nerve (RSN) entrapment (25 cases).
• Nerve entrapment was bilateral in 25% of affected patients, with a common mechanism involving hands on the steering wheel during frontal or rear impacts.

Conclusions:

• Motor vehicle collisions (MVCs) are a significant cause of upper extremity nerve entrapments, including CTS, CT, and RSN.
• The findings suggest a direct causal link and a plausible pathomechanism for these injuries.
• Early recognition of this association is crucial for timely diagnosis and treatment of nerve compression syndromes after MVCs.