桡骨远端畸形愈合矫正截骨术后的腕管综合征：1例罕见病例报告及文献复习
Carpal Tunnel Syndrome Following Corrective Osteotomy for Distal Radius Malunion: A Rare Case Report and Review of the Literature.
作者信息
Gary Cyril, Shah Ajul, Kanouzi Jack, Golas Alyssa R, Frey Jordan D, Le Brian, Hacquebord Jacques, Thanik Vishal
机构信息
1 Yale University, School of Medicine, Division of Plastic Surgery, New Haven, CT, USA.
2 New York University, School of Medicine, Deparment of Plastic Surgery, New York City, USA.
出版信息
Hand (N Y). 2017 Sep;12(5):NP157-NP161. doi: 10.1177/1558944717708053. Epub 2017 May 16.
BACKGROUND
Although median nerve neuropathy and carpal tunnel syndrome (CTS) are known complications of both untreated and acutely treated distal radius fracture, median neuropathy after correction of distal radius malunion is not commonly reported in hand surgery literature. We describe a patient with severe CTS after corrective osteotomy, open reduction internal fixation (ORIF) with a volar locking plate (VLP), and bone grafting for distal radius malunion.
METHODS
We report a case of severe acute CTS as a complication of corrective osteotomy with bone grafting for distal radius malunion.
RESULTS
The patient was treated with surgical exploration of the median nerve and carpal tunnel release.
CONCLUSION
The authors report a case of acute CTS after ORIF with VLP for a distal radius malunion warranting surgical exploration and carpal tunnel release. Treatment teams must be aware of this potential complication so that the threshold for reoperation is low and irreversible damage to the median nerve is prevented.
背景
虽然正中神经病变和腕管综合征（CTS）是未经治疗和急性治疗的桡骨远端骨折已知的并发症，但在手部外科文献中，桡骨远端畸形愈合矫正后正中神经病变并不常见。我们描述了1例在进行截骨矫正、掌侧锁定钢板（VLP）切开复位内固定（ORIF）及植骨治疗桡骨远端畸形愈合后出现严重CTS的患者。
方法
我们报告1例严重急性CTS病例，该病例为桡骨远端畸形愈合截骨矫正联合植骨的并发症。
结果
患者接受了正中神经手术探查及腕管松解术治疗。
结论
作者报告1例采用VLP进行ORIF治疗桡骨远端畸形愈合后出现急性CTS的病例，该病例需要进行手术探查及腕管松解。治疗团队必须意识到这种潜在并发症，以便降低再次手术阈值并防止正中神经发生不可逆损伤。
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