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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(02): 347-350
DOI: 10.1055/s-0040-1714228
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Acute Carpal Tunnel Syndrome due to Persistent Median Artery thrombosis: Case report[*]

Article in several languages: português | English
Yussef Ali Abdouni 
1   Departamento de Ortopedia e Traumatologia, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
,
João Pedro Farina Brunelli 
2   Grupo de Cirurgia da Mão, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
,
Marco Antônio Soares Munia 
3   Departamento de Cirurgia Vascular, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
› Author Affiliations Financial Support The authors declare that they have not received financial support from public, private, or non-profit sources for the conduction of the present study.
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Abstract

Carpal tunnel syndrome is the most common compressive neuropathy of the upper limb, affecting ∼ 4% of the general population. The clinical picture is characterized by pain and, mainly, paresthesia in the median nerve territory, of insidious onset and, in the most severe cases, loss of strength and atrophy of the thenar musculature is observed. It is an extremely common pathology in the daily practice of hand surgery, and in most cases, it can be treated with conservative methods. We present here an atypical case of carpal tunnel syndrome, of acute onset, triggered by persistent median artery (PMA) thrombosis, condition associated with distal embolization and hypoperfusion of the limb.

Keywords

carpal tunnel syndrome - thrombosis - arteries - compressive syndrome

* Work developed at the Department of Orthopedics and Traumatology, Irmandade of Santa Casa de Misericórdia of São Paulo, São Paulo, SP, Brazil.




Publication History

Received: 10 April 2020

Accepted: 05 May 2020

Article published online:
25 September 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Referências

  • 1 Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282 (02) 153-158
    CrossrefPubMedGoogle Scholar
  • 2 Katz JN, Larson MG, Sabra A. et al. The carpal tunnel syndrome: diagnostic utility of the history and physical examination findings. Ann Intern Med 1990; 112 (05) 321-327
    CrossrefPubMedGoogle Scholar
  • 3 De Abreu LB, Moreira RG. Median-nerve compression at the wrist. J Bone Joint Surg Am 1958; 40-A (06) 1426-1427
    CrossrefPubMedGoogle Scholar
  • 4 Lindley SG, Kleinert JM. Prevalence of anatomic variations encountered in elective carpal tunnel release. J Hand Surg Am 2003; 28 (05) 849-855
    CrossrefPubMedGoogle Scholar
  • 5 Kleinert JM, Fleming SG, Abel CS, Firrell J. Radial and ulnar artery dominance in normal digits. J Hand Surg Am 1989; 14 (03) 504-508
    CrossrefPubMedGoogle Scholar
  • 6 Mazer N, Barbieri CH, Zatiti SCA, Velludo MAL. Síndrome do túnel carpal aguda associada a trombose da artéria mediana persistente. Rev Bras Ortop 1993; 28 (04) 201-203
    Google Scholar
  • 7 Chammas M, Boretto J, Burmann LM, Ramos RM, Santos Neto FC, Silva JB. Síndrome do túnel do carpo - Parte I (anatomia, fisiologia, etiologia e diagnóstico). Rev Bras Ortop 2014; 49 (05) 429-436
    CrossrefPubMedGoogle Scholar
  • 8 Lavey EB, Pearl RM. Patent median artery as a cause of carpal tunnel syndrome. Ann Plast Surg 1981; 7 (03) 236-238
    CrossrefPubMedGoogle Scholar
  • 9 Barfred T, Højlund AP, Bertheussen K. Median artery in carpal tunnel syndrome. J Hand Surg Am 1985; 10 (6 Pt 1): 864-867
    CrossrefPubMedGoogle Scholar
  • 10 Gassner EM, Schocke M, Peer S, Schwabegger A, Jaschke W, Bodner G. Persistent median artery in the carpal tunnel: color Doppler ultrasonographic findings. J Ultrasound Med 2002; 21 (04) 455-461
    CrossrefPubMedGoogle Scholar