Published online Oct 28, 2017. doi: 10.4329/wjr.v9.i10.400
Peer-review started: February 14, 2017
First decision: April 19, 2017
Revised: June 24, 2017
Accepted: July 7, 2017
Article in press: July 10, 2017
Published online: October 28, 2017
Intraosseous entrapment of the median nerve is an uncommon complication of elbow dislocation and fractures. The condition is seen to occur in adolescent age group with a remote history of trauma. We report two rare cases of type 2 intraosseous median nerve entrapment. Though the diagnosis of median neuropathy is made with clinical tests and neurophysiological studies, however exact site of entrapment and presurgical mapping of nerve is done accurately with MR neurography. Imaging thus plays a pivotal role in management of this condition.
Core tip: Intraosseous entrapment of median nerve at the level of elbow joint is rare but serious complication of closed reduction of posterior elbow dislocation. We report two cases of type 2 intraosseous medan nerve entrapment (wherein the median nerve gets entrapped in fractured medial epicondyle) and discuss the role of MR neurography. MR delineates the posterior course of median nerve with altered signal intensity, thickening and loss of fascicular pattern. In addition, secondary denervation changes in muscles supplied by median nerve is indirect evidence of nerve pathology. Management of such cases would differ depending on the time of diagnosis.