INTRODUCTION: Compression of the median nerve at the wrist by a persistent median artery is one of the uncommon reasons for carpal tunnel syndrome. Most of the studies in the literature deal with thrombosed persistent median artery. MATERIALS AND METHOD: In this study, we present surgical treatment of four carpal tunnel syndromes, which had persistent median arteries. The mean age of the patients was 51 years. All four median arteries were patent and only transverse carpal ligament releases were performed using a standard anterior open approach for decompression of the carpal tunnel. Neither ligation nor transposition of the arteries was done. RESULTS: All patients became symptom free after a few weeks. Only one patient had a slight recurrence 13 months postoperatively. Splint use and modification of her activities reduced her disturbance, and no further treatment was applied. CONCLUSION: If the patient has no additional anomaly, our clinical experiences lead us not to advise resection or transposition because simple release of the transverse carpal ligament can relieve symptoms.
INTRODUCTION: Compression of the median nerve at the wrist by a persistent median artery is one of the uncommon reasons for carpal tunnel syndrome. Most of the studies in the literature deal with thrombosed persistent median artery. MATERIALS AND METHOD: In this study, we present surgical treatment of four carpal tunnel syndromes, which had persistent median arteries. The mean age of the patients was 51 years. All four median arteries were patent and only transverse carpal ligament releases were performed using a standard anterior open approach for decompression of the carpal tunnel. Neither ligation nor transposition of the arteries was done. RESULTS: All patients became symptom free after a few weeks. Only one patient had a slight recurrence 13 months postoperatively. Splint use and modification of her activities reduced her disturbance, and no further treatment was applied. CONCLUSION: If the patient has no additional anomaly, our clinical experiences lead us not to advise resection or transposition because simple release of the transverse carpal ligament can relieve symptoms.
Authors: Clay B Townsend; Daniel Seigerman; Daren Aita; Daniel Fletcher; Greg Gallant; Christopher Jones; Moody Kwok; Robert Takei; Mark Wang; Pedro Beredjiklian Journal: Arch Bone Jt Surg Date: 2022-09