Schelo C, Kröger K, Hinrichs A, Rensing N, Rudofsky G
Klinik für Angiologie, Universitätsklinikum Essen.
Vasa. 1997 Nov;26(4):311-3.
Upper extremity ischemia with finger necrosis: carpal-tunnel syndrome or thoracic outlet syndrome? A 26-year-old male patient complained of pain paraesthesia in the right upper extremity while working with the arm elevated. After electrophysiological diagnosis of a carpal-tunnel-syndrome the patient received surgical treatment. Following this treatment he developed acral necrosis at the fingers. Additional diagnostic effort let to the diagnosis of a thoracic-outlet-syndrome due to a cervical rib. This case report and a review of the literature show that electrophysiological investigations alone can not differentiate the carpal-tunnel-syndrome from the thoracic-outlet-syndrome. Thus an operative release of a carpal-tunnel should not be performed until the arterial perfusion of the upper extremity has been judged.
腕管综合征还是胸廓出口综合征？一名26岁男性患者在抬高手臂工作时出现右上肢疼痛和感觉异常。经电生理诊断为腕管综合征后，患者接受了手术治疗。治疗后，他的手指出现了肢端坏死。进一步的诊断检查发现是由于颈肋导致的胸廓出口综合征。本病例报告及文献回顾表明，仅靠电生理检查无法区分腕管综合征和胸廓出口综合征。因此，在判断上肢动脉灌注情况之前，不应进行腕管切开手术。
