Leclère F M P, Unglaub F, Gohritz A, Hahn P
Vulpiusklinik, Akademisches Lehrkrankenhaus der Universität Heidelberg, Vulpiusstraße 29, 74906 Bad Rappenau, Germany.
Neurochirurgie. 2012 Oct;58(5):309-13. doi: 10.1016/j.neuchi.2012.05.002. Epub 2012 Jun 28.
Hemihyperplasia of the upper extremity is a rare pathology that occurs in 1/86,000 births. Carpal tunnel syndrome may be associated with this disease.
We describe the case of a 74-year-old male who has hemihyperplasia of both upper extremities since birth. At the age of 73, he started experiencing continuous, progressive and high intensity pain that occurred more frequently at night and was localized in the right hand. It was associated with paresthesia and hypoesthesia predominantly of the thumb, index finger and middle finger. Clinical examination and electrodiagnosis led to diagnosis of carpal tunnel syndrome.
The patient underwent surgical carpal tunnel release to treat the disease. The enlarged nerve was compressed by a supernumerous lumbrical muscle, which was resected intraoperatively. After six months of follow-up the patient has normal sensitivity and grip strength in the right hand.
Hemihyperplasia should be clearly distinguished from other complex pathologies that may also entail CTS. Since significant variation in the anatomy of the hemihyperplasic extremities is the rule rather than the exception, a conventional open approach should be taken to localize and treat the compression.
上肢半侧肥大是一种罕见的病理状况，发病率为1/86,000。腕管综合征可能与该疾病相关。
我们描述了一名74岁男性的病例，他自出生起就患有双上肢半侧肥大。73岁时，他开始出现持续、进行性且高强度的疼痛，夜间更为频繁，疼痛部位在右手。疼痛伴有主要累及拇指、食指和中指的感觉异常和感觉减退。临床检查和电诊断确诊为腕管综合征。
患者接受了腕管松解手术来治疗该疾病。术中发现正中神经被一条额外的蚓状肌压迫，遂将其切除。经过六个月的随访，患者右手感觉和握力恢复正常。
半侧肥大应与其他可能导致腕管综合征的复杂病理状况明确区分。由于半侧肥大肢体的解剖结构存在显著变异是常态而非例外，因此应采用传统的开放手术方法来定位和治疗压迫。
