Sensory sequelae of injuries to the median nerve

: Median nerve wounds are frequent because of the superficial course of this nerve, especially in the wrist. The sensory sequellae of such lesions, either complete or dissociated, represent a major handicap which may be associated to a motor impairment of the external thenar muscles. The curative procedures such as neurolysis and, above all, sutures or grafts, must be very widely used, even some time after the initial injury and in spite of motor reinnervation. The role of palliative surgery is therefore limited, although it is sometimes useful. There are many procedures, which may be summed up by two techniques: use of sensitive neurovascular skin flaps, the most frequent grafts, neurotization of the median nerve with a transfer of sensory rami from the radial nerve, a less-known technique. The treatment of the sensory sequellae of median nerve lesions is primarily based on a good initial management of the nerve lesions by a good-quality emergent microsurgical suture.