Zusammenfassung
Das akute Karpaltunnelsyndrom (ACTS) ist selten und meist Folge von Frakturen des distalen Radius oder der Handwurzelknochen. Beschrieben wird erstmalig ein ACTS nach Handgelenkprellung durch ein isoliertes massives Hämatom der Beugesehnenscheiden, welches sich jedoch erst ca. 50 Stunden nach dem Trauma rasant entwickelte. Der Patient leidet an einem Marfan-Syndrom. Bei diesem sind neben Veränderungen der großen Gefäße, insbesondere der Aorta, auch solche der Peripherie nachgewiesen. Spekulativ wird ursächlich für das Hämatom von einer Aneurysmablutung eines kleinen Gefäßes ausgegangen. Therapie der Wahl beim ACTS ist die notfallmäßige Karpaltunnelspaltung.
Abstract
Acute carpal tunnel syndrome (ACTS) is rare and is mostly the result of fractures of the distal radius or the carpal bones. This paper gives the first report of an ACTS following contusion of the wrist as the result of an extensive haematoma of the flexor tendon sheath, which did not appear until 50 hours after the injury was sustained but then developed rapidly. The patient suffers from Marfan syndrome. This disease is associated with pathologic changes to the major vessels, and especially the aorta, and of the smaller peripheral vessels. It is assumed that the haematoma arose from an aneurysm of such a small vessel. The treatment of choice in ACTS is emergency incision of the carpal tunnel.
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Franke, J., Wenzel, W., Rehfuß, D. et al. Akutes Karpaltunnelsyndrom bei Marfan-Syndrom. Unfallchirurg 111, 358–360 (2008). https://doi.org/10.1007/s00113-007-1329-0
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DOI: https://doi.org/10.1007/s00113-007-1329-0