Hernández-Coria A E, Estrada-Marín C I, Herce-Santisteban A, Bonfil-Ojeda J R
Servicio de Ortopedia Pediátrica del Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México. México.
Star Médica Hospital Infantil Privado. México.
Acta Ortop Mex. 2022 Jul-Aug;36(4):248-251.
the association of carpal tunnel syndrome with stenosing tenosynovitis of the hand is very rare, even more, if it is generated by a fibrolipoma at the carpal tunnel. The imaging study useful to detect this type of hand injuries are X-ray screening for carpal tunnel, computed tomography and magnetic resonance imaging. But these are not commonly used for the study of protocolized carpal tunnel syndrome and much less trigger finger.
the aim of this work is to report a case of a middle-aged female with carpal tunnel syndrome characteristic symptoms, associated with the third trigger finger; she was handled with the release of the median nerve by a minimally invasive approach, in addition to the A1 pulley release.
the patient persists with both problems and at a secondary surgical review, we detected wrist locking sensation. The patient was reoperated finding an ovoid encapsulated tumor, measuring 3.0 × 2.0 × 1.0 cm, with smooth outer surface, whitish appearance, and soft rubbery consistency. The biopsy pathology outlines identified an encapsulated fibrolipoma, causing nerve compression and locking flexor tendon.
the importance of this writing is in adding tumors to the etiological repertoire, which can cause compression of the median nerve and even less frequent as a cause of the flexor tendons of the hand snagging.
腕管综合征与手部狭窄性腱鞘炎的关联非常罕见，若由腕管内的纤维脂肪瘤引发则更为罕见。用于检测此类手部损伤的影像学检查包括腕管的X线筛查、计算机断层扫描和磁共振成像。但这些检查在标准化腕管综合征的研究中并不常用，在扳机指的研究中使用得更少。
本文旨在报告一例具有腕管综合征典型症状且伴有第三指扳机指的中年女性病例；除了A1滑车松解术外，还通过微创方法对正中神经进行了松解。
患者的这两个问题持续存在，在二次手术复查时，我们发现了腕部锁定感。再次手术时发现一个椭圆形包膜肿瘤，大小为3.0×2.0×1.0厘米，外表面光滑，呈白色，质地软橡皮样。活检病理检查确定为包膜纤维脂肪瘤，导致神经受压和屈肌腱卡顿。
本文的重要性在于将肿瘤纳入病因学范畴，肿瘤可导致正中神经受压，作为手部屈肌腱卡顿的病因则更为少见。
