McCollam Grace, Chun Tristan, McCollam Stephen
Tulane University School of Medicine, New Orleans, LA.
Peachtree Orthopedic Clinic, Atlanta, GA.
J Hand Surg Glob Online. 2023 Feb 1;5(2):250-252. doi: 10.1016/j.jhsg.2023.01.001. eCollection 2023 Mar.
This case study examines a 45-year-old man who presented with advanced ulnar innervated intrinsic muscle atrophy in the hand, and clawing of the ring and little fingers. This case is unique due to discovery of an anomalous distal forearm muscle with the spontaneous onset and rapid nature of progressive neuropathic symptoms. Further, this patient demonstrated primarily intrinsic motor deficits and denied any sensory deficits on presentation. At surgery, an anomalous distal forearm muscle was found to be compressing the ulnar nerve. This muscle crossed in an oblique fashion, originating from the volar forearm fascia and inserted into the pisiform and proximal abductor digiti minimi fascia. At 5 months after surgery, the patient's ulnar innervated intrinsic muscle strength was improved but still not normal. This case study details the patient's presentation, assessment, surgical management, and postoperative outcome.
本病例研究考察了一名45岁男性，其手部出现尺神经支配的手部内在肌严重萎缩，以及环指和小指爪形畸形。该病例独特之处在于发现了一块前臂远端异常肌肉，且伴有进行性神经病变症状的自发发作和快速发展。此外，该患者主要表现为手部内在肌运动功能缺损，就诊时否认有任何感觉功能缺损。手术中发现一块前臂远端异常肌肉压迫尺神经。此肌肉呈斜行穿过，起自前臂掌侧筋膜，止于豌豆骨和小指展肌近端筋膜。术后5个月，患者尺神经支配的手部内在肌力量有所改善，但仍未恢复正常。本病例研究详细介绍了患者的临床表现、评估、手术治疗及术后结果。
