scholarly journals Persistent median artery carpal tunnel syndrome: a case series and literature review

2019 ◽  
Vol 2 (1) ◽  
pp. 93-98 ◽  
Author(s):  
Jake L Nowicki ◽  
Alexander Macgregor Cameron ◽  
Philip Griffin ◽  
Quoc Tai Khoa Lam ◽  
Nicholas Marshall
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Literature Review ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Case Series ◽  
Management Options ◽  
Tunnel Syndrome ◽  
Median Artery

Persistent median artery (PMA) thrombosis is a rare cause of carpal tunnel syndrome (CTS) with only a few cases reported in the literature. The bifid median nerve (BMN) is often associated with PMA and may be a factor in the development of CTS. There is a paucity of information in the literature on the management options for CTS secondary to PMA thrombosis. This paper presents two cases of CTS with associated PMA thrombosis and BMN and offers a discussion on diagnostic and management options.

A PERSISTENT MEDIAN ARTERY AND BIFID MEDIAN NERVE IN THE SETTING OF CARPAL TUNNEL SYNDROME

2012 ◽  
Vol 15 (02) ◽  
pp. 1272004
Author(s):  
M. Lee Spangler ◽  
Emad Almusa ◽  
Cynthia Britton
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Imaging Features ◽  
Anatomic Variants ◽  
Tunnel Syndrome ◽  
Median Artery

We present a case of bifid median nerve and a persistent median artery presenting in the setting of carpal tunnel syndrome. The importance of these anatomic variants and their imaging features and workup are discussed.

scholarly journals Incidental finding of a persistent median artery (palmar type) during a routine carpal tunnel decompression: a case report

2017 ◽  
Vol 99 (7) ◽  
pp. e204-e205
Author(s):  
J Butt ◽  
AK Ahluwalia ◽  
A Dutta
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Incidental Finding ◽  
Surgical Decompression ◽  
Iatrogenic Injury ◽  
Palmar Fascia ◽  
Tunnel Syndrome ◽  
Median Artery

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.

Student Section

1977 ◽  
Vol 44 (3) ◽  
pp. 144-144
Author(s):  
Rosemary Weiss
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Clinical Picture ◽  
Neutral Position ◽  
Wrist Movement ◽  
Tunnel Syndrome ◽  
Median Artery

A closer look at splinting for carpal tunnel syndrome (CTS) is necessary, since it is suggested that there are two types of CTS. 1) neural CTS, with a typical clinical picture of injury of the median nerve and, 2) vascular CTS where the early dominant symptoms are ischemic due to compression of a) a persisting median artery and, b) the radial and ulnar arteries Preventing wrist movement and excessive gripping during the day, alleviates compression of the radial, ulnar and possibly persisting median artery, and the median nerve. Thus, a release phenomenon does not occur at night. It is suggested that the wrist be splinted in a functional splint during the day, and a resting splint during the night, supporting the wrist in both cases, in a neutral position.

Canaletto implant in revision surgery for carpal tunnel syndrome: 21 case series

2011 ◽  
Vol 37 (7) ◽  
pp. 682-689 ◽  
Author(s):  
A. Bilasy ◽  
S. Facca ◽  
S. Gouzou ◽  
P. A. Liverneaux
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Case Series ◽  
Invasive Technique ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
Quick Dash ◽  
Perineural Fibrosis

Revision carpal tunnel surgery varies from 0.3% to 19%. It involves a delayed neurolysis and prevention of perineural fibrosis. Despite numerous available procedures, the results remain mediocre. The aim of this study is to evaluate the results of the Canaletto implant in this indication. Our series includes 20 patients (1 bilateral affection) reoperated for carpal tunnel between October 2008 and December 2009. After the first operation, the symptom-free period was 112 weeks, on average. The average incision was 27 mm. After neurolysis, the Canaletto implant was placed in contact with the nerve. Immediate postoperative mobilization was commenced. Sensory (pain, DN4, and hypoesthesia), motor (Jamar, muscle wasting), and functional (disabilities of the arm, should, and hand; DASH) criteria were evaluated. Nerve conduction velocity (NCV) of the median nerve was measured. Average follow up was 12.1 months. All measurements were improved after insertion of the Canaletto implant: pain (6.45–3.68), DN4 (4.29–3.48), Quick DASH (55.30–34.96), Jamar (66.11–84.76), NCV (29.79–39.06 m/s), hypoesthesia (76.2–23.8%), wasting (42.9–23.8%). Nevertheless, four patients did not improve, and pain was the same or worse in six cases. Our results show that in recurrent carpal tunnel syndrome, Canaletto implant insertion gives results at least as good as other techniques, with the added advantage of a smaller access incision, a rapid, less invasive technique, and the eliminated morbidity of raising a flap to cover the median nerve.

scholarly journals Atypical Carpal Tunnel Syndrome in a Holt Oram Patient: A Case Report and Literature Review

2014 ◽  
Vol 8 (1) ◽  
pp. 462-465
Author(s):  
James Mace ◽  
Srikanth Reddy ◽  
Randeep Mohil
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
Carpal Tunnel Syndrome ◽  
Literature Review ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Clinical Effect ◽  
Resonance Imaging ◽  
Tunnel Syndrome

We present a case report of a patient diagnosed with Holt-Oram syndrome (HOS) presenting with clinical and electrophysiologically confirmed carpal tunnel syndrome. Pre-operative Magnetic resonance imaging revealed an abnormal course of the median nerve; as such an atypical incision and approach were carried out to decompress the nerve to excellent post operative clinical effect. To our knowledge this is the first description of abnormal nervous course in a patient with HOS leading to peripheral entrapment. A literature surrounding the important aspects of HOS to the orthopaedic surgeon is presented concomitantly.

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