Search

Epithelioid sarcoma is an infrequent tumour, especially in upper limb, which nerve spread is not common. We describe the case of a 27 years old caucasian male with initial diagnosis of Dupuytren's disease. He underwent palmar fascia surgery, but the surgical treatment was followed by recurrence of the deformity in retraction of 4th and 5th finger of the left hand. When he presented himself at our attention, the patient underwent surgical biopsy and new histological examination was made with diagnosis of epithelioid sarcoma. We highlight essentially two aspects of this case: the diagnostic delay of tumour caused by simulation of the Dupuytren's disease and the atypical perineural spread along the median nerve.

Purpose: Carpal Tunnel Syndrome (CTS) is a neuropathy caused by compression of the median nerve at the level of the wrist, which is caused by different pathologic conditions. In some cases it has been associated with anatomic variations of the median nerve, mainly with the early duplication of the nerve inside the carpal tunnel (III Group of Lanz). The treatment of CTS is mainly surgical consisting in decompression by transection of the transverse carpal ligament, which is better performed by endoscopic release. The aim of our study was to evaluate the possibility to detect this anatomic variant by integrated imaging and assess the value of this information for planning treatment., Material and Methods: We report 6 cases of bifid median nerve examined by Ultrasonography (US) using mechanic sectorial and linear array transducers operating at 10 to 13 MHz, and by MR imaging using 0.2 T equipment., Results: In all cases US transverse scans showed two adjacent oval formations with a structure similar to that of the median nerve. CONCLUSIONS. MR imaging confirmed the sonographic findings in all cases. All patients underwent open surgical treatment by decompression of the median nerve; in all cases an early duplicated median nerve was confirmed.

Carpal tunnel syndrome is the most frequent among entrapment neuropathies. It is mainly due to entrapment of the median nerve at wrist level. The authors analyze conservative treatment options, which can be useful in the early stages of the disease. Afterward, they compare various surgical techniques. The goal of surgery is to reduce the pressure on the nerve by cutting the transverse carpal ligament. Surgery can be accomplished with open carpal tunnel release or endoscopic carpal tunnel release. Open techniques can, in rare cases, cause scar problems. On the other hand, endoscopic surgery techniques can cause iatrogenic problems. [ABSTRACT FROM AUTHOR]

The preferable operation for dynamic renewal in cases of inveterate paralysis of median nerve (where nervous recovery through grafting is impossible) is carried out by transferring to the thumb the sublimis flexor of the fourth finger, basically using S. Bunnell's technique. Condition for operation's success is the integrity of short extensor and especially of the longus abductor, which, nerved by the radial, help to place before thumb's column. The authors discuss the results of eight cases checked from two and five years after the operation. The best results have been achieved in cases of low isolated paralysis of the median nerve.

Copyright of Il Fisioterapista is the property of Edi.Ermes S.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Il Fisioterapista is the property of Edi.Ermes S.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Arterial and nerve lesions may be an important complication in forearm and wrist surgery, because of the close relationship between neurovascular bundles and the common surgical accesses. The most frequently involved structure is the median nerve, while vascular injuries are less common. [ABSTRACT FROM AUTHOR]

mong compression neuropathies of the median nerve in the forearm we discuss the one affecting the anterior interosseous nerve (AIN), called Kiloh-Nevin syndrome. Literature is confusing since several sites of compression are enclosed in a misleading nomenclature. Diagnosis is mostly clinical but electrodiagnostic techniques may help in surgical indication. Surgery is often unnecessary since recovery usually occurs with conservative treatment. A difficult decision is required on timing of surgery since literature recommendations are not evidence-based. [ABSTRACT FROM AUTHOR]

Femmina di 75 anni con IRC da nefropatia interstiziale per abuso di analgesici, inizia nel 2000 trattamento con CAPD e nel 2002 viene immessa in emodialisi con bicarbonato di 12 ore settimanali. Viene successivamente sottoposta ad interventi di artroprotesi d'anca e per sindrome del tunnel carpale da ambo i lati. Inizia quindi HDF on line con membrana high-flux da 2 m2 di superficie. Ripresenta progressiva tumefazione al polso destro, con dolore ed incapacità prensile degli oggetti. L'EMG del nervo mediano presenta elementi tipici per sindrome del tunnel carpale destro. I livelli serici di β2-microglobulina restano persistentemente elevati (in postdialisi: 39,37 mcg/mL). L'ecografia con sonda lineare da 13 MHZ mostra incremento dell'area cross sectional del nervo mediano destro (0,14 cm2), con inglobamento dello stesso all'interno di formazione compatibile con tessuto amiloide. L'RM, preliminare al reintervento, conferma i reperti ecografici. Nella diagnosi di sindrome del tunnel carpale da β2m-amiloidosi l'ecografia con sonde small part costituisce un efficace metodica di conferma della diagnosi clinica, che può consentire di riservare l'uso di altre tecniche più dispendiose, in particolare l'RM, a casi selezionati, di maggior complessità clinica.