Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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29-AUGUST-2012 MUNTAHA SALEH SHAMOUT 75 YEARS
CHEMICAL INJURY TO THE RIGHT RADIAL NERVE AT THE ELBOW AND RIGHT CTS.
The patient came to the clinic 17-July-2012
complaining of drop right wrest and hand after
injection to the right radial nerve at the elbow
level 2 months ago. She has headache and
tinnitus for 6 years and fainting attacks for 3
months. The patient is a known diabetic with
On examination, the patient has tinnitus right
ear and pain when looking up and down and
fainting when looking to the right. She has drop
right wrest and hand. There is painful mass when
palpating the radial nerve at the elbow level.
MRI cervical spine done 25-July-2012 showing
spondylolisthesis C4-5 and small extrusion C5-6.
MRI of the brain showed scattered lacunar
infarctions both cerebral hemisphere,
periventricular more in the left side. EMG and
ECS done 250July-2012 confirming non-function of
the right radial nerve and severe carpal tunnel
syndrome right side.
The right radial nerve was
identified and explored at the entire length of
the lower third of the arm and upper third of
the forearm. There was no proper neuroma and the
nerve was adherent with the surrounding
structures. There was only motor response when
using 8 mA DNS using ISIS Inomed EMG. After
neurolysis of the nerve to the healthy portions
proximally and its branches distally, the nerve
could achieve response with 2 mA DNS. Even the
nerve was atrophied, but responding to such
stimulation, neurolysis was decided to be the
final step. Right carpal tunnel release done.
Routine closure of the wounds. Smooth
The nerve was responding to 2 mA DNS after neurolysis.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
It hard to tell preoperatively, the exact
nature of the lesion. Studying the nerve during exploration
is the only solution to decide what best to the patient.
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Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .