It seems like I have some serious competition, I ran across this electronic textbook of hand surgery, that also keeps a case of the week. It looks like I may be thieving quite a few Monday Hand Wounds from them in the future. Anyways, without further ado:
The patient was shot in the hand last year – the details are unclear. He has a stellate scar in the center of the palm with some powder burn type tattooing around the scar. There are no other scars. There is severe thenar muscle atrophy as well as dry atrophic skin in the median nerve distribution. He has poor thumb abduction and poor flexion of the fingers, complete anesthesia in the median nerve distribution and a strong Tinel sign in the proximal palm.