Shahriari Shawhin R, O'Brien Cameron, Avant Kristopher
Department of Orthopedic Surgery, Integris Health, Oklahoma City, USA.
Orthopedic Surgery, College of Osteopathic Medicine, Oklahoma State University, Tulsa, USA.
Cureus. 2025 May 5;17(5):e83522. doi: 10.7759/cureus.83522. eCollection 2025 May.
Vascular anomalies of the upper extremity are rare and often challenging to diagnose. The ulnar artery, a terminal branch of the brachial artery, typically traverses the forearm and enters the hand through Guyon's canal, where vascular pathologies have been implicated in ulnar tunnel syndrome. However, vascular anomalies occurring outside Guyon's canal, such as a tortuous ulnar artery in the distal forearm, are seldom reported and remain poorly understood. We report the case of a 57-year-old male with a palpable mass on the volar/ulnar aspect of his distal forearm, which was associated with intermittent pain during hand use. Surgical exploration of the suspected mass revealed a tortuous ulnar artery without evidence of vascular malformations. To alleviate symptoms and reduce palpability, the artery was buried beneath the fascia. Postoperatively, the patient experienced complete symptom resolution with no recurrence of the mass or symptoms at three months postoperatively. This case represents the third reported instance of a palpable, tortuous ulnar artery as a distal forearm mass. This highlights a rare clinical entity that resulted in symptomatic resolution with both diagnostic and therapeutic surgical intervention. This also exemplifies the need for a broad differential diagnosis, a step-wise approach, and intimate knowledge of anatomy when treating masses of the forearm.
上肢血管异常较为罕见，诊断往往具有挑战性。尺动脉是肱动脉的终末分支，通常穿过前臂并通过Guyon管进入手部，血管病变与尺管综合征有关。然而，发生在Guyon管外的血管异常，如前臂远端的尺动脉迂曲，鲜有报道，人们对此仍知之甚少。我们报告一例57岁男性患者，其前臂远端掌侧/尺侧可触及肿块，手部活动时伴有间歇性疼痛。对疑似肿块进行手术探查发现尺动脉迂曲，无血管畸形证据。为缓解症状并减少可触及性，将该动脉埋于筋膜下。术后，患者症状完全缓解，术后三个月肿块及症状均未复发。该病例是第三例报道的可触及的迂曲尺动脉作为前臂远端肿块的病例。这凸显了一种罕见的临床实体，通过诊断性和治疗性手术干预实现了症状缓解。这也例证了在处理前臂肿块时，需要进行广泛的鉴别诊断、采取逐步的方法以及深入了解解剖结构。
