Two Cases of Atypical Incomplete Median Nerve Palsy.

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Two cases of atypical incomplete median nerve palsy are reported. A 33 and a 26 year-old male had severe pain around the radial forearm and elbow joints. Several weeks later, they found they could not flex the IP joint of their thumbs. On physical examination FPL, FCR, pronator teres and pronator quadratus were not functioning but there was no sensory change in the median nerve region. The patients did not show any signs of recovery and were operated on within 6 months of onset. Surgical exploration revealed no entrapment points along the median nerve, however, some of the median nerve fasciculus was semitransparent along its entire length. Histological examination of the terminal branch of the anterior interosseus nerve revealed Wallerlian degeneration without inflammatory changes. The FPL was reconstructed with tendon transfer using PL or BR with both patients regaining early function of the thumb.