Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

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What to Learn from this Article?

Ulnar nerve was ligated while primary suturing of the wound, however it manifested 2 weeks later when open reduction internal fixation was performed. An highly unusual presentation and lessons learned from it.


Case Report |  Volume 3 | Issue 3 | JOCR July-Sep 2013 | Page 15-17 | Mothilal M, Mothilal S N, Ravichandran S, Mohammad J.


Authors: Mothilal M[1], Mothilal S N[1], Ravichandran S[2], Mohammad J[1]

[1]Sri Satya Sai Medical College & Research Institute, Chennai-603108, India.

[2]Dept Of Orthopaedics, Mahatma Gandhi Medical College & Research Institute, Pondicherry – 607402.

 Address of Correspondence:

Dr Murali Mothilal: Sri Satya Sai Medical College & Research Institute, Chennai-603108, India. Email: muraliorth@gmail.com


Abstract

Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound.

Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient.

Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial.

Keywords: Iatrogenic, ulnar nerve palsy.


 

How to Cite This Article: Mothilal M, Mothilal S N, Ravichandran S, Mohammad J. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation. Journal of Orthopaedic Case Reports 2013 July-Sep ;3(3):15-17. Available from: http://test.jocr.co.in/2013/07/10/2250-0685-108-fulltext/


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