Ulus Travma Acil Cerrahi Derg. 2013; 19(2): 186-188 | DOI: 10.5505/tjtes.2013.92332

Radial sinir duyusal dalýnýn iki taraflý izole kesisi

Nuray Akkaya¹, Hakan Ramazan Özcan², Ýnci Gökalan Kara², Füsun Þahin^1
1Pamukkale Üniversitesi, Týp Fakültesi, Fizik Tedavi Ve Rehabilitasyon Anabilim Dalý
²Pamukkale Üniversitesi, Týp Fakültesi, Plastik Ve Rekonstrüktif Cerrahi Anabilim Dalý

Giriþ: Radial sinir duyusal dalýnýn (RSDD) iki taraflý yaralanmalarý genellikle sýký takýlmýþ kelepçe nöropatisi sonucunda oluþur. Bu vakada daha önce literatürde bildirilmemiþ yaralanma mekanizmasý ile oluþan bilateral izole RSDD kesisinin sunulmasý amaçlandý.
Vaka sunumu: Yirmi-dört yaþýnda, cam fabrikasýnda iþçi, erkek hasta sunuldu. Ýþ kazasý sonucu olarak cam kýrýlmasý ile el bilekleri dorsolateralinde oluþan cilt kesisi, baþvurduðu saðlýk merkezinde primer suture edilmiþ. Hasta 1 ay sonra geçmeyen hissizlik ve aðrý nedeniyle Plastik ve Rekonstrüktif Cerrahi Bölümüne baþvurmuþ ve cerrahi planlanmýþ. Cerrahi sýrasýnda gözlenen skar doku ve RSDD kesik uçlarýnda oluþan nöroma temizlenmiþ ve
Bilateral RSDD kesisi tamir edilmiþ.
Hastanýn Fizik Tedavi ve Rehabilitasyon Bölümündeki muayenesinde, bilateral baþparmak dorsal yüzünde ve sol 1. web aralýðýnda hafif duyusal kayýp ve sað el bileði fleksiyonunda kýsýtlýlýk olduðu saptandý. Operasyon sonrasý 3. ay muayenesinde sað el bileði eklem hareket açýklýðý tam, duyusal defisitler ve hiperestezi azalmýþtý.
Sonuç: RSDD baþparmak dorsalinin duyusunu saðlar, o nedenle yaralanmasý önemli fonksiyonel kayýba neden olmaz. Ancak, RSDD’nin aðrýlý nöroma geliþimine yatkýnlýðý nedeniyle, izole RSDD yaralanmasýnýn taný, tedavi ve takibinin yapýlmasý yaþam kalitesini bozan olasý aðrýlý nöropatinin önlemesi için faydalý olacaktýr.

Anahtar Kelimeler: Radial sinir duyusal dalý, önkol sinir yaralanmasý, nöroma.

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Bilateral isolated cut of sensory branch of radial nerve

Nuray Akkaya¹, Hakan Ramazan Özcan², Ýnci Gökalan Kara², Füsun Þahin^1
1University Of Pamukkale, Faculty Of Medicine, Department Of Physical Medicine And Rehabilitation
²University Of Pamukkale, Faculty Of Medicine, Department Of Plastic And Reconstructive Surgery

Introduction: Bilateraly injuries of sensory branch of radial nerve(SBRN) usually occur as a result of tight handcuff neuropathy.In this case we aimed to present bilateral isolated cut of SBRN with an injury mechanism which has not been reported in the literature yet.
Case-presentation: Twenty-four years old, a worker in a glass factory, male patient was presented.His dorsolateral skin cut of wrists due to breaking of the glass as a result of occupational accident was primarily sutured in a healthcare center.The patient consulted again after a month because of the lingering numbness and pain, and surgery was planned.In the surgery observed scar tissue and neuroma around cut ends of SBRN were excised, and bilateral SBRN cut were repaired.Four weeks after operation, mild sensory deficit on dorsal side of bilateral thumbs, and left first web space, and flexion limitation on right wrist were detected. At postoperative 3rd month, right wrist joint range of motion were full, sensory deficits, and hyperesthesia was decreased.
Results: SBRN elicits the sensory innervation of thumb dorsum so its injury does not cause important functional deficit.However because of susceptibility of SBRN to develop painful neuroma, diagnosis, treatment and follow up of isolated SBRN injury would be worthwhile for prevention of possible painful neuropathy disturbing the quality of life.

Keywords: Sensory branch of radial nerve, nerve injury of forearm, neuroma

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