Carpal Tunnel Syndrome Produced by an Organising Haematoma Within the Anomalous Second Lumbrical Muscle

HAND ◽  
1981 ◽  
Vol os-13 (1) ◽  
pp. 87-91 ◽  
Author(s):  
A. Nather ◽  
R. W. H. Pho
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Complete Relief ◽  
Anomalous Muscle ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle

A rare case of carpal tunnel syndrome due to an anomalous second lumbrical muscle passing through the carpal tunnel is described. Its presentation as an organising haematoma in the anomalous muscle due to trauma precipitating the syndrome has not been reported in the literature previously. The anomalous muscle with its contained haematoma was excised with complete relief of symptom.

scholarly journals First Lumbrical Muscle Flap for Recurrence of Carpal Tunnel Syndrome: Anatomical Study and Surgical Technique

2021 ◽  
Vol 49 (01) ◽  
pp. 079-087
Author(s):  
Esther Fernández Tormos ◽  
Fernando Corella Montoya ◽  
Blanca Del Campo Cereceda ◽  
Montserrat Ocampos Hernández ◽  
Teresa Vázquez Osorio ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Muscle Flap ◽  
Anatomical Study ◽  
Physical Barrier ◽  
Adjacent Structures ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle

AbstractRecurrence of carpal tunnel syndrome implies the reappearance of symptoms after release surgery. If the cause of recurrence is not an incomplete release, but a traction neuritis, the tendency is to add to the revision surgery of the carpal tunnel the use of flaps to cover the median nerve. These flaps establish a physical barrier between the nerve and the rest of the adjacent structures, preventing adhesions, and providing neovascularization and better nerve sliding.In the present work, we detail a revision surgery in which the first lumbrical muscle is used as a covering flap. This flap has two benefits. Firstly, it acts as a vascularized coverage for the median nerve (avoiding the formation of fibrosis and favoring its sliding); secondly, a structure that takes up space is removed from the carpal tunnel, thus reducing the pressure within it.Along with the explanation of the technique, the present article provides a detailed description of the anatomical variability of the first lumbrical muscle and its vascularization, as well as the results of a cadaveric study on the location of the vascular pedicle of the first lumbrical muscle.

scholarly journals Thrombosis of persistent median artery as a cause of carpal tunnel syndrome : case report

2021 ◽  
Vol 87 (3) ◽  
pp. 529-532
Author(s):  
S Arnauw ◽  
G De Wachter
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Treatment Options ◽  
Surgical Excision ◽  
Acute Onset ◽  
Complete Relief ◽  
Anatomical Variant ◽  
Tunnel Syndrome ◽  
Median Artery

Carpal tunnel syndrome (CTS) is a common peripheral neuropathy, caused by compression of the median nerve. Symptoms usually are present for months and aggravate over time. Acute onset of complaints and symptoms, like coldness of the hand, should raise awareness of a possible vascular cause of CTS.Persistent median artery (PMA) is a very rare anatomical variant of the blood supply of the upper limb. The presence of a thrombosed PMA is an extremely rare cause of CTS. In this article a case is presented in which the patient has carpal tunnel syndrome of his left hand, caused by a thrombosed persistent median artery. Conservative treatment, consisting of rest, ice applica- tion and non-steroidal anti-inflammatory drugs, failed. Surgical excision of the thrombosis and open exploration of the carpal tunnel was performed, with complete relief of symptoms. In literature different treatment options, like conservative treatment with antiplatelet therapy or surgical excision of the throm- bosis and decompression of the nerve, are described with good results. However up until now, no consensus exists about the golden standard in treatment of a thrombosed persistent median artery.

Acute Carpal Tunnel Syndrome Caused by Anomalous Muscle Bellies: A Case Report

Hand Surgery ◽  
2003 ◽  
Vol 08 (01) ◽  
pp. 141-143 ◽  
Author(s):  
Hiroshi Kono
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical Situation ◽  
Perilunate Dislocation ◽  
Anomalous Muscle ◽  
Operative Exploration ◽  
Tunnel Syndrome ◽  
Flexor Digitorum ◽  
Acute Carpal Tunnel Syndrome

We reported on an acute carpal tunnel syndrome that occurred two hours after the internal fixation of scaphoid. Operative exploration showed median nerve compression caused by flexor digitorum superficialis muscle bellies within the carpal tunnel. Symptoms were relieved immediately after the carpal tunnel release. This case was very rare because acute carpal tunnel syndrome was caused by swollen muscle bellies within the carpal tunnel after the initial operation for the trans-scaphoid perilunate dislocation. This clinical situation should be distinguished from compartment syndrome of forearm.

Carpal tunnel syndrome caused by thrombosis of the median artery: importance of high-resolution ultrasonography for diagnosis

2002 ◽  
Vol 97 (2) ◽  
pp. 471-473 ◽  
Author(s):  
Henrich Kele ◽  
Raphaela Verheggen ◽  
Carl Detlev Reimers
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Content Type ◽  
The Third ◽  
Tunnel Syndrome ◽  
Median Artery ◽  
High Resolution Ultrasonography ◽  
Fine Print

✓ The rare case of a patient with carpal tunnel syndrome caused by thrombosis of a persistent median artery is presented. Progressive pain in the wrist and dysesthesias in the third and fourth fingers were the atypical complaints. High-resolution ultrasonography revealed a bifid median nerve that was compressed by an occluded median artery. The intraoperative findings are described, and emphasis is placed on the importance of using high-resolution ultrasonography for presurgical diagnosis.

scholarly journals Carpal tunnel syndrome caused by thrombosed persistent median artery - A case report -

2020 ◽  
Vol 15 (2) ◽  
pp. 193-198
Author(s):  
Sang Yoon Jeon ◽  
Kwangmin Lee ◽  
Weon-Joon Yang
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Severe Pain ◽  
Rare Case ◽  
Conservative Therapy ◽  
Cervical Radiculopathy ◽  
Resonance Imaging ◽  
Chief Complaints ◽  
Tunnel Syndrome ◽  
Median Artery

A rare case of carpal tunnel syndrome caused by a thrombosed persistent median artery is presented here. The diagnosis was delayed due to the overlapping cervical radiculopathy. Acute severe pain and nocturnal paresthesia were chief complaints. Ultrasonography, magnetic resonance imaging, and computed tomography angiography revealed that the median nerve was compressed by the occluded median artery. Instead of surgery, conservative therapy was tried. It worked well for six months. The importance of using modalities for decision making of diagnosis and treatment is emphasized in this report.

scholarly journals Anomalous Flexor Digitorum Superficialis Muscle Transposition for Vascular Coverage of the Median Nerve in Recurrent Carpal Tunnel Syndrome

2005 ◽  
Vol 13 (1) ◽  
pp. 27-30
Author(s):  
Michael W Neumeister ◽  
Arian Mowlavi ◽  
Robert C Russell ◽  
Bradon J Wilhelmi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Excellent Result ◽  
Vascular Supply ◽  
Flexor Digitorum Superficialis ◽  
Palmar Fascia ◽  
Anomalous Muscle ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

Recurrent carpal tunnel syndrome is uncommon yet troublesome. Significant adhesions and scarring around the median nerve can render it relatively ischemic. A number of vascular flaps have been described to provide vascular coverage in attempts to decrease further cicatricial adhesions and to improve local blood supply around the median nerve. A rare case of an anomalous muscle in the distal forearm used as tissue to provide good vascularized coverage of the median nerve that was severely scarred in its bed is reported. The anomalous muscle was distal to the flexor digitorum superficialis tendon and inserted in the palmar fascia on the ulnar aspect of the hand. Referring branches from the ulnar artery provided vascular supply to the anomalous muscle. The muscle on these vascular pedicles was transposed over the median nerve, providing good, stable, unscarred coverage. The patient had an excellent result with resolution of the carpal tunnel symptoms. The redundant anomalous muscle provided a unique vascularized source for coverage of the median nerve in recurrent carpal tunnel syndrome.

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