Palumbo Dante, Miller Aden, Smock Elliott, Farner Scott
Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY, USA.
Kleinert Kutz Hand Care Center, Louisville, KY, USA.
SAGE Open Med Case Rep. 2019 Jan 11;7:2050313X18823355. doi: 10.1177/2050313X18823355. eCollection 2019.
Muscle herniation in the upper extremity is a rare but recognized phenomenon with a paucity of reports in the current literature. In the majority of cases, the herniation is secondary to trauma, with some of the cases due to muscle hypertrophy and increased intra-compartmental pressure from the forced exertion. Treatment for this condition ranges from nonsurgical, repair, or reconstruction to fasciotomy of the flexor carpi ulnaris fascia. Here, we present a case of flexor carpi ulnaris herniation after an open in situ cubital tunnel release in a 57-year-old male 6 years after initial surgery. The patient's symptoms did not improve with conservative management, and the patient subsequently underwent endoscopic fasciotomy with resolution of his symptoms and maintenance of his wrist and grip strength. The rationale for the treatment chosen is discussed.
上肢肌肉疝是一种罕见但已被认识的现象,目前文献中报道较少。在大多数情况下,疝是由创伤引起的,有些病例是由于肌肉肥大以及用力时肌室内压力增加所致。这种疾病的治疗方法包括非手术治疗、修复或重建,以及尺侧腕屈肌筋膜切开术。在此,我们报告一例57岁男性在初次手术后6年进行原位开放式肘管松解术后出现尺侧腕屈肌疝的病例。患者经保守治疗症状未改善,随后接受了内镜下筋膜切开术,症状得以缓解,手腕和握力得以维持。文中讨论了所选治疗方法的依据。