Isolated Fascial Compression of the Recurrent Motor Branch of the Median Nerve: A Case Report

Isolated compression of the recurrent motor branch (RMB) of the median nerve is not commonly reported. This report deals with a case of fascial band compression of the RMB of the median nerve with sparing of the sensory portion of the nerve in a single patient. The episode was precipitated by the subject was clearing fallen trees after an ice storm. Symptoms occurred only in the left, nondominant hand of the patient, a 43-year-old invasive cardiologist. He presented within weeks of symptom onset, but marked clinical and electrodiagnostic abnormalities of the branch were already present. Timely decompression after evaluation led to a successful clinical outcome, with restoration of full strength on manual muscle testing by 6 months postoperatively and marked electrodiagnostic improvements as well by 11 months after operation. Final clinical examination 16 months after operation showed thenar muscle bulk and strength well maintained.