The median nerve in the distal underarm and inner side of the hand is entrapped.
This causes especially during the night pain in the thumb and the index fingers. There is a painful sensation of pins and needles and sometime a loss of strength also. Many patients complain of symptoms when they bicycle due to the position of he hands.
First therapeutic steps are anti-inflammatory medication and volar splints for the night.
When neuro-physiological examination shows a severe impingement an operation to achieve decompression will be indicated. By means of microsurgical technique the operation trauma is minimised so that no temporary fixation of the hand will be necessary.