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In-continuity neuroma of the median nerve after surgical release for carpal tunnel syndrome: case report

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Abstract

Iatrogenic injuries of the median nerve after surgical release for carpal tunnel syndrome resulting in the formation of a neuroma are rare. We present here the case of two patients, one with a bifid median nerve, showing in-continuity neuroma after surgical release for carpal tunnel syndrome. The patients reported persistent post-operative pain and showing symptoms. In both cases, ultrasound showed an in-continuity neuroma with a hypoechoic and enlarged median nerve at the carpal tunnel. The case report shows that ultrasound may be helpful in confirming the clinical diagnosis of neuroma and it is useful for evaluation of the percentage of the area affected by the tear.

Riassunto

Le lesioni iatrogene del nervo mediano, dopo intervento chirurgico per sindrome del tunnel carpale, determinanti la formazione di un neurinoma sono rare. Nel seguente case report, sono presentati due pazienti, uno dei quali con un nervo mediano bifido, con neuroma-in-continuità formatosi dopo intervento chirurgico per sindrome del tunnel carpale. I pazienti avevano dolore postoperatorio persistente e un peggioramento della sintomatologia con il passare del tempo. In entrambi i casi, l’ecografia ha mostrato un neuroma-in-continuità con un nervo mediano aumentato in dimensioni ed ipoecogeno a livello del tunnel carpale. Il case report mostra che l’ecografia può essere utile per confermare la diagnosi clinica di neuroma ed è utile per la valutazione della percentuale della superficie interessata dalla lacerazione.

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Conflict of interest

All authors declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All patients provided written informed consent to enrolment in the study and to the inclusion in this article of information that could potentially lead to their identification.

Human and animal studies

The study was conducted in accordance with all institutional and national guidelines for the care and use of laboratory animals.

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Authors and Affiliations

  1. Radiology Unit, Moncucco Hospital, Lugano, Switzerland

    R. Depaoli

  2. Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, Pavia, Italy

    D. R. Coscia

  3. Foundation IRCCS, Policlinico San Matteo, Institute of Radiology, University of Pavia, Pavia, Italy

    F. Alessandrino

Authors
  1. R. Depaoli
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  2. D. R. Coscia
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  3. F. Alessandrino
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Correspondence to F. Alessandrino.

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Depaoli, R., Coscia, D.R. & Alessandrino, F. In-continuity neuroma of the median nerve after surgical release for carpal tunnel syndrome: case report. J Ultrasound 18, 83–85 (2015). https://doi.org/10.1007/s40477-014-0127-0

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  • DOI: https://doi.org/10.1007/s40477-014-0127-0

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