Abstract
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and typically progresses slowly. Intraoperatively, flexor tenosynovitis, nerve edema, or hourglass deformity may be observed. In rare cases, acute compression symptoms occur due to mass effect on the nerve. Intraneural hematoma of the median nerve is uncommon and has been reported primarily in acute CTS cases associated with trauma. This report describes an 87-year-old patient with a history of mild CTS who underwent carpal tunnel release due to worsening symptoms. After the initial incision, a thickened flexor retinaculum, an hourglass deformity of the median nerve, and an intraneural hematoma were identified. The hematoma was incised and drained without evidence of new hematoma formation. Postoperatively, the patient experienced rapid improvement of symptoms. This case highlights an unusual intraoperative finding in CTS and broadens the differential considerations for median nerve pathology encountered during routine carpal tunnel release.
Recommended Citation
Silva, Ana; Gil Gonrtre; Nikalus Skipp; Ana Love; and Deana Mercer. "Median Nerve Intraneural Hematoma as an Intraoperative Finding During Carpal Tunnel Release: A Case Report." Western Journal of Orthopaedics 15, 1 (2026). https://digitalrepository.unm.edu/wjo/vol15/iss1/15