1/10. median nerve compression associated with displaced Salter-Harris type II distal radial epiphyseal fracture.Three children with grossly displaced Salter-Harris Type II fractures of the distal radial epiphysis underwent immediate manipulation under anaesthetic (MUA) because of rapidly developing median nerve compression. In each case nerve function was quickly restored with no late neurological sequelae. We believe that in children who sustain this injury with signs of median nerve compression, immediate MUA without carpal tunnel release is acceptable initial management. Late exploration of the median nerve can be considered should a neurological deficit persist.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/10. Bilateral median nerve compression at the level of Struthers' ligament. Case report.Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.- - - - - - - - - - ranking = 1.5keywords = compression (Clic here for more details about this article) |
3/10. Contribution of magnetic resonance imaging for the diagnosis of median nerve lesion after endoscopic carpal tunnel release.Deterioration of pre-existing signs or appearance of a nerve deficit raise difficult problems during the complicated course following endoscopic carpal tunnel release. One possible explanation is transient aggravation of nerve compression by passage of the endoscopy material, but these signs may also be due to incomplete section of the flexor retinaculum or an iatrogenic nerve lesion. Each case raises the problem of surgical revision. The authors report three cases of open revision in which MRI allowed a very precise preoperative diagnosis of the lesions and all of the MR findings were confirmed during surgical revision. In the first case, MRI showed section of the most radial branches of the median nerve (collateral nerves of the thumb, index finger and radial collateral nerve of the middle finger). The proximal origin of the nerve of the 3rd web space, above the retinaculum, an anatomical variant, was also identified. Section of 2/3 of the nerve of the 3rd web space, proximal to the superficial palmar arch, was observed in the second case. Simple thickening of the nerve of the 3rd web space, without disruption after opening of the perineurium, was observed in the third case. MRI therefore appears to be an examination allowing early and precise definition of indications for surgical revision in this new iatrogenic disease.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
4/10. Synovial osteochondromatosis at the elbow producing ulnar and median nerve palsy. Case report and review of the literature.The authors present the case of a 53-year-old woman suffering from synovial osteochondromatosis of her right elbow responsible for ulnar and median nerve entrapment neuropathy. This condition is characterised by the formation of multiple cartilaginous nodules in the metaplastic synovium of otherwise normal joints, bursae or tendon sheaths. Treatment consisted of partial synovectomy, removal of loose bodies and microscopic nerve release. Synovial osteochondromatosis complicated by nerve compression syndromes has been rarely reported, usually with ulnar tunnel syndrome at the elbow. The literature on this subject is reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
5/10. median nerve compression by a radially inserted palmaris longus tendon after release of the antebrachial fascia: A complication of carpal tunnel release.We describe a case that had recurrent median nerve compression after release of the antebrachial fascia in carpal tunnel release. The nerve was compressed by a palmaris longus tendon that was inserted radially into the thenar fascia. After decompression (detachment of the tendon) the patient had symptom relief. Release of the antebrachial fascia in the presence of this tendon variant carries a risk of median nerve compression by the tendon.- - - - - - - - - - ranking = 1.1666666666667keywords = compression (Clic here for more details about this article) |
6/10. Postoperative edema after vascular access causing nerve compression secondary to the presence of a perineuronal lipoma: case report.OBJECTIVE AND IMPORTANCE: median nerve neuropathy can be clinically devastating to a patient. It can be caused by compression of the median nerve anywhere along its course. We present the case of delayed median nerve neuropathy after the placement of a vascular graft in the arm. CLINICAL PRESENTATION: An arm shunt was placed in the nondominant upper extremity in a 60-year-old man with end-stage renal disease. Twelve hours postoperatively, the patient developed neurapraxia in the median nerve distribution in the hand. INTERVENTION: Exploration of the arm revealed a lipoma coursing along and deep to the median nerve. Resection of the lipoma decompressed the nerve. CONCLUSION: In this patient, median nerve neuropathy was caused by a lipoma and postoperative swelling from placement of the vascular graft. The swelling that occurred after the shunt placement unmasked subclinical compression of the nerve by a lipoma deep to the median nerve. To our knowledge, this report is unique in documenting damage to the median nerve after vascular graft placement as a result of an occult mass.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/10. Anterior interosseous nerve and multifocal motor neuropathy.We report the case of a 47-year-old woman with a left anterior interosseous nerve palsy. Surgical release of the anterior interosseous nerve was initially proposed, but electrodiagnostic evaluation demonstrated that the neuropathy was due not to compression or to neuralgic amyotrophy but to a proximal conduction block. At that time, the conduction block could be defined only by indirect electrodiagnostic criteria. A multifocal motor neuropathy with persistent conduction block was subsequently diagnosed, and the patient was treated with intravenous immunoglobulins. The efficacy of this treatment and the subsequent disclosure of conduction block in the right posterior interosseous and peroneal nerves definitively confirmed the multifocal motor neuropathy.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
8/10. Concomitant compression of median and ulnar nerves in a hemophiliac patient: a case report.A 15-year-old boy, with a diagnosis of hemophilia a, suffered bleeding into his left forearm 5 months before being admitted to our medical center. His neurological examination revealed a pronounced median neuropathy and a minor ulnar neuropathy on the left side. There was marked muscle atrophy on the thenar side and, to a lesser degree, on the hypothenar side and in the forearm. Electromyographic findings demonstrated an evident, nearly complete, sensorimotor axonal loss in the median nerve. magnetic resonance imaging studies showed atrophy in muscles of the left forearm and median nerve. The patient was diagnosed as having median nerve axonotmesis and ulnar nerve neuropraxia due to compartment syndrome. In hemophiliac patients, frequent single nerve compressions (often involving the femoral nerve) can be seen. However, concomitant median and ulnar nerve injuries with differing severity are rare.- - - - - - - - - - ranking = 0.83333333333333keywords = compression (Clic here for more details about this article) |
9/10. Combined median and medial antebrachial cutaneous neuropathies: an upper-arm neurovascular syndrome.The neurovascular bundle anatomy in the upper arm displays changing relationships of nerve and vascular structures along short segments. Fibrous tissues segregate these elements into enclosed compartments allowing for specific patterns of injury. We report a patient with a iatrogenic brachial artery injury in this region who featured combined median and MAC neuropathies, which were consistent with complete axonotmesis on neurophysiological assessment. Increased intracompartmental pressure may have led to nerve injury either thorough an ischemic mechanism or to focal compression. Recognition of this unusual pattern of nerve damage is important, since injury can be accurately localized to the midportion of the neurovascular compartment in the upper arm.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
10/10. Lipofibromatous hamartoma of the median nerve with long-term follow-up.Lipofibromatous hamartoma is a rare, benign tumor that most often involves the median nerve. A 16-year-old male with lipofibromatous hamartoma of the median nerve at the wrist level is described. This patient was a child when the mass was first noted. Although there were no symptoms or signs of carpal tunnel compression, the growth of the tumor was progressing. In addition to the release of the carpal tunnel, microsurgical intraneural dissection was done to preserve the thenar motor branch. Then segmental excision of the residual sensory component with sural nerve grafting was performed. Subjectively the patient did not notice the minor motor deficit, however, the patient did experience numbness of fingertips after surgery. There were no scars or trophic ulcers on fingertips at 3 years of follow-up regardless of the inadequate sensory return. Treatment of this benign tumor is still controversial. The relevant reports in the literature are reviewed.- - - - - - - - - - ranking = 0.16666666666667keywords = compression (Clic here for more details about this article) |
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