Vital Luísa, Vidinha Vitor, Neves Nuno, Negrão Pedro
Médicos Ortopedistas, Departamento de Ortopedia e Traumatologia, Centro Hospitalar Universitário de São João, Porto, Portugal.
Rev Bras Ortop (Sao Paulo). 2020 Oct 29;58(4):e659-e661. doi: 10.1055/s-0040-1718509. eCollection 2023 Aug.
Supracondylar apophysis (SA) is a bony prominence that originates from the anteromedial aspect of the distal humerus with a lower projection and which, although usually asymptomatic, due to the relationship with adjacent structures can cause symptoms. We describe the case of a 42-year-old woman with pain complaints radiating from her elbow to her hand, with 6 months of evolution. On objective examination, the patient had a sensory deficit in the median nerve territory and decreased grip strength. Radiographs of the distal humerus were performed, in which a bone spike was visible, and magnetic resonance imaging showed thickening of the median nerve epineurium. Electromyography showed severe axonal demyelination of the median nerve proximal to the elbow. A median nerve compression caused by a SA was diagnosed. The patient underwent surgery and, 1 year after the operation, she had a complete clinical recovery. Supracondylar apophysis is a rare, but possible and treatable cause of high median nerve compression.
肱骨髁上骨突（SA）是一种骨隆起，起源于肱骨远端的前内侧，突出较低，尽管通常无症状，但由于与相邻结构的关系可能会引起症状。我们描述了一名42岁女性的病例，她主诉肘部至手部有放射痛，病程6个月。体格检查时，患者在正中神经分布区域存在感觉障碍，握力下降。对肱骨远端进行了X线检查，可见骨棘，磁共振成像显示正中神经神经外膜增厚。肌电图显示肘部近端正中神经严重轴索性脱髓鞘。诊断为SA导致的正中神经受压。患者接受了手术，术后1年临床完全恢复。肱骨髁上骨突是正中神经高位受压的一种罕见但可治的病因。
