Double crush syndrome due to plating of humeral shaft fracture

Median nerve injury is rarely associated with the humeral shaft fracture. A Sixty two year old woman with a displaced humeral shaft fracture, developed a symptomatic carpal tunnel syndrome after plating with a screw protruding medially. 16 months later, the implants were removed and the symptoms gradually improved without carpal tunnel release surgery. A double crush syndrome resulted due to the proximal compression by the medially protruding screw and the distal compression by carpal tunnel. The proximal decompression produced by removal of the screw led to relief of the symptoms.