Ultrasound evaluation of carpal tunnel and median nerve in malunited Colles′ fracture

Abstract

Introduction: Colles′ fractures continue to be one of the most common skeletal injuries of middle aged and elderly population. Compressive neuropathy is one of the most important complications of Colles′ fractures and usually involves the median nerve. The objective of our study was to investigate the impact of malunion of Colles′ fracture on the anatomy and dimensions of the carpal tunnel and the median nerve. Materials and Methods: Fifty cases of Colles′ fracture were included in this study, which was conducted for a period of 2 years. Radiographic and ultrasonographic evaluation was done in all patients. Nerve conduction studies were done in four patients diagnosed with carpal tunnel syndrome (CTS). Results: From our study, it was seen that there was a significant decrease in the dimensions of the carpal tunnel and median nerve in Colles′ fracture based on ultrasonographic evaluation and the loss of radial length and volar shift were the two parameters significant in patients suffering from a CTS, based on radiographic evaluation. There was also an increase in the motor and sensory nerve conduction latency on nerve conduction studies of the median nerve. Conclusion: The loss of radial length and presence of a volar shift of the distal radius are the two deformities when left uncorrected may predispose to a CTS.

Keywords

• Carpal tunnel syndrome
• malunited Colles′ fracture
• radiographic evaluation
• ultrasonographic evaluation