PMC7369452_01
Transverse scar as a result of cut down procedure.
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Local examination revealed a 2 cm transverse surgical scar mark (from the venous cut down procedure) present at the medial aspect of right arm just proximal to the elbow crease (Fig. 1).
"Pinch Test/OK Sign" showing the weakness of flexor pollicis longus and flexor digitorum profundus of index finger.
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He was unable to do the "OK sign", which suggested weakness of the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) of index finger (Fig. 2). "Pointing finger sign" was positive due to the inability to flex PIP and DIP joints of index finger (Fig. 3).
"Pointing finger sign" due to inability to flex PIP and DIP joints of index finger.
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He was unable to do the "OK sign", which suggested weakness of the flexor pollicis longus (FPL) and flexor digitorum profundus (FDP) of index finger (Fig. 2). "Pointing finger sign" was positive due to the inability to flex PIP and DIP joints of index finger (Fig. 3).
Median Nerve found ligated with a suture.
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Upon exploration, it was noted that the median nerve was tightly tied circumferentially with a non absorbable suture, (most likely being an ethilon suture, which is same as used to close the skin) forming a constriction band (Fig. 4).
The constriction band was released and external neurolysis done.
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The constriction band was released and external neurolysis done (Fig. 5).
Two weeks post operatively, patient was able to flex PIP joint of index finger.
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Around two weeks post operatively, it was noted that patient was able to flex PIP joint of index finger (Fig. 6).
At four months follow up, patient was able to completely flex the PIP and DIP joints of index finger and make a fist.
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During follow-up visit, at around 4 months, he showed complete recovery in the function of the muscles of the hand innervated by median nerve i.e. flexor digitorum superficialis, lateral half of the flexor digitorum profundus and flexor pollicis longus and was able to make a full fist (Fig. 7).