Electrophysiological and Ultrasonographic Evaluation of Palmar Digital Nerve Injury in Distal Finger

Abstract

Electrophysiological evaluation of distal lesions in the palmar digital branch of the median nerve presents a significant challenge. We present a case of lateral palmar digital neuropathy of the median nerve, which was confirmed through clinical, electrophysiological, and ultrasonographic assessments. A 54-year-old woman was referred to our electrophysiology laboratory for persistent numbness and a tingling sensation on the radial side of the distal phalanx of her left second finger. She had a laceration injury on the middle phalanx of the second finger and underwent neurorrhaphy of the lateral branch of the palmar digital nerve 8 months ago. Sensory nerve conduction studies, both antidromic and orthodromic, showed low amplitude responses for the lateral branch of the palmar digital nerve. Ultrasonography revealed swelling of this nerve branch within the middle phalanx of the second finger. When patients report sensory symptoms in a specific area, it is important to evaluate for potential cutaneous nerve injuries using electrophysiological studies. Additionally, high-resolution ultrasonography is a valuable tool for investigating small cutaneous nerve lesions, even in the distal finger.