A 35-year-old presents with inability to oppose the thumb and sensory loss over the thenar eminence following a laceration at the wrist. Tinel's sign is positive at the wrist crease. The most appropriate surgical procedure is:

• A Immediate carpal tunnel decompression only
• B Opponensplasty using the flexor digitorum superficialis of the ring finger
• C Neurolysis of the recurrent branch of the median nerve
• D Primary or delayed primary repair of the median nerve with microsurgical epineural suture ✓

Explanation

A sharp median nerve laceration at the wrist in a young patient is best managed by primary microsurgical nerve repair (within 72 hours if wound is clean) or delayed primary repair (within 3 weeks). Epineural suture under magnification provides the best functional outcome at this level. Opponensplasty is a secondary reconstructive procedure for irreversible median nerve palsy. Neurolysis is for intraneural scarring without complete disruption.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.