scholarly journals Tophaceous Gout Causing the Carpal Tunnel Syndrome and Flexor Digitorum Dysfunction: A Case Report

2021 ◽  
Vol 11 (2) ◽  
pp. 154-160
Author(s):  
D. Y. Kulakov ◽  
V. V. Lyalina ◽  
E. A. Skripnichenko ◽  
S. G. Pripisnova ◽  
A. A. Maksimov ◽  
...  

Carpal tunnel syndrome is the most common peripheral compression neuropathy and can be caused by many diseases and conditions, including the formation of gouty tophi in various structures of the tunnel. This publication provides a review of literature and a case report on Carpal tunnel syndrome in a 58-year-old male patient with tophaceous gout. The case is characterized by the extremely rare combination of median nerve compression and tendons dysfunction due to the tophi deposits in the flexor tendons of the hand.

2020 ◽  
Vol 15 (01) ◽  
pp. e1-e4
Author(s):  
Amgad S. Hanna ◽  
Zhikui Wei ◽  
Barbara A. Hanna

AbstractMedian nerve anatomy is of great interest to clinicians and scientists given the importance of this nerve and its association with diseases. A rare anatomical variant of the median nerve in the distal forearm and wrist was discovered during a cadaveric dissection. The median nerve was deep to the flexor digitorum superficialis (FDS) in the carpal tunnel. It underwent a 360-degree spin before emerging at the lateral edge of FDS. The recurrent motor branch moved from medial to lateral on the deep surface of the median nerve, as it approached the distal carpal tunnel. This variant doesn't fall into any of Lanz's four groups of median nerve anomalies. We propose a fifth group that involves variations in the course of the median nerve. This report underscores the importance of recognizing variants of the median nerve anatomy in the forearm and wrist during surgical interventions, such as for carpal tunnel syndrome.


2017 ◽  
Vol 99 (7) ◽  
pp. e204-e205
Author(s):  
J Butt ◽  
AK Ahluwalia ◽  
A Dutta

Carpal tunnel syndrome is characterised by compression of the median nerve. The mainstay of treatment is surgical decompression. This case report highlights the occurrence of a persistent median artery, which could complicate surgery. A 55-year-old woman underwent carpal tunnel decompression. An incidental finding of a large-calibre persistent median artery, which was superficial to the flexor sheath, could have been damaged. This was carefully retracted and the procedure was completed, without any complications. Several studies have shown the prevalence of persistent median artery to range from 1.1–27.1%. It is usually found deep to the flexor retinaculum but in this case it was found to be just beneath the palmar fascia. There is increased chance of iatrogenic injury with this particular variant. Surgeons performing the procedure should be mindful of this variation, because accidental damage could result in devastating consequences to the hand.


Author(s):  
Behzad Enayati ◽  
Mahmoud Farzan ◽  
Shahram Akrami ◽  
Pouya Tabatabaei Irani ◽  
Alireza Moharrami

Background: Trigger wrist is a rare disease with few reported cases in the literature. This condition presents with painful sensation and a clicking sound during finger or wrist movements. Case Report: In this report, we present a 32-year-old man suffering from trigger wrist along with carpal tunnel syndrome caused by muscle belly hypertrophy and extension to the carpal tunnel. The diagnostic approach and surgical techniques are explained. Conclusion: In cases of trigger wrist associated with carpal tunnel syndrome (CTS), there may be an underlying cause covering both the trigger wrist and CTS at the volar side of the wrist. Therefore, a precise clinical examination is recommended to avoid unnecessary surgery, releasing of A1 pulley, or steroid injection.  


Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 327-330 ◽  
Author(s):  
D. Cumming ◽  
A. Massraf ◽  
J. W. M. Jones

We report a case of carpal tunnel syndrome as a result of an extraosseous chondroma in a 47-year-old gentleman. This case demonstrates the importance of clinical examination and occasional radiographs in this not uncommon condition. We also highlight that this well known entrapment syndrome is not only caused by the common causes that we all know, but also any space-occupying lesion in the carpal tunnel compressing the median nerve.


2005 ◽  
Vol 13 (1) ◽  
pp. 27-30
Author(s):  
Michael W Neumeister ◽  
Arian Mowlavi ◽  
Robert C Russell ◽  
Bradon J Wilhelmi

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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