Kostoris Francesco, Bassini Stefania, Longo Emiliano, Murena Luigi
1 Orthopaedics and Traumatology Unit, Cattinara Hospital, ASUITS, Trieste, Italy.
J Hand Surg Asian Pac Vol. 2019 Jun;24(2):238-242. doi: 10.1142/S2424835519720123.
The anatomic variations of the median nerve and of the muscles of the wrist have been widely reported in literature. It is essential for the surgeon to be familiar with these variations in order to avoid accidental injury to the nerve during surgery. We report a rare case of bifid median nerve accompanied by an anomalous tendon of palmaris profundus discovered during the surgical release of carpal tunnel. The transverse carpal ligament was dissected and the anomalous tendon was left in situ because any direct compression over the median nerve was noticed intraoperatively. The patient was evaluated one year postoperatively clinically and radiologically (with MRI). At the follow up the resolution of symptoms was complete and the sleep disturbance was solved. The patient achieved a postoperative QuickDASH score of 9.1 and a Michigan Hand Questionnaire outcome score of 90 points.
正中神经及腕部肌肉的解剖变异在文献中已有广泛报道。外科医生熟悉这些变异对于避免手术过程中意外损伤神经至关重要。我们报告了一例罕见的双叉正中神经病例，该病例在腕管松解术中发现伴有一条异常的掌深肌腱。切开腕横韧带后，由于术中未发现正中神经受到任何直接压迫，故将异常肌腱留在原位。术后一年对患者进行了临床和影像学评估（磁共振成像）。随访时症状完全缓解，睡眠障碍得到解决。患者术后QuickDASH评分为9.1分，密歇根手功能问卷结果评分为90分。
