Altaf Warid, Attarde Dheeraj, Sancheti Parag
Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
J Clin Orthop Trauma. 2020 Oct;11(Suppl 5):S889-S891. doi: 10.1016/j.jcot.2020.06.029. Epub 2020 Jul 4.
Atypical presentation of tuberculosis is not uncommon in developing countries. Among extra-pulmonary sites, tendons are very rarely involved. Compound palmar ganglion associated with tuberculosis is an uncommon condition in which a swelling is present across the wrist joint on either side of the flexor retinaculum. Very rarely such lesion can compress over neural structures and may present as Carpal Tunnel Syndrome. A therapeutic challenge consists of treating disease and its associated presentation. Treatment of choice for such conditions include complete excision of the mass along with the radical synovectomy of the wrist joint and associated flexor tendon sheaths followed by anti-tubercular medications. With early diagnosis and treatment good recovery can be achieved. We present a Case of a large compound tubercular palmar ganglion who presented to us with symptoms of carpal tunnel syndrome which was treated surgically with excision and carpal tunnel release.
在发展中国家,非典型肺结核并不罕见。在肺外部位中,肌腱很少受累。与结核相关的复合性掌部腱鞘囊肿是一种罕见病症,在屈肌支持带两侧的腕关节处会出现肿胀。这种病变极少会压迫神经结构,可能表现为腕管综合征。治疗难题在于既要治疗疾病又要处理其相关表现。此类病症的首选治疗方法包括完整切除肿块,同时对腕关节及相关屈肌腱鞘进行根治性滑膜切除术,随后使用抗结核药物。早期诊断和治疗可实现良好恢复。我们报告一例大型复合性结核性掌部腱鞘囊肿病例,该患者因腕管综合征症状前来就诊,通过手术切除和腕管松解进行了治疗。