B. Al-Dhafer, Sang Young Kim, Y. Shin, J. Kim, Shin Woo Choi
Purpose: Failed carpal tunnel surgery poses a challenge for the attending surgeon(s). Numerous revision techniques have been reported in the literature, with evidence of long-term improvement. However, studies exploring how early could symptomatic improvement be detected are scarce. The objective of this study was to identify the speed of symptom(s) recovery after a repeated decompression technique using an open standard incision and median external nerve neurolysis with no supplemental procedures.Methods: Nine patients who underwent revision carpal tunnel surgery involving standard incision, external median neurolysis, and no supplemental techniques between June 2017 and June 2020, were included. Data regarding the preoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score, Disabilities of the Arm, Shoulder and Hand score, visual analogue score, and grip strength were collected and compared with evaluation results at 3 months postoperatively. Results: In all patients, severe adhesion of the median nerve with the surrounding soft tissue was confirmed intraoperatively. Compared with preoperative findings, 3-month evaluation of patients demonstrated a statistically significant improvement in the BCTQ symptoms score and pain score. All nine patients were satisfied with the procedure. Conclusion: Standard incision and median nerve external neurolysis can be a good option for recalcitrant carpal tunnel syndrome patient who has an adhesion of the median nerve with surrounding soft tissue.
{"title":"Standard incision and median nerve external neurolysis for recalcitrant carpal tunnel syndrome","authors":"B. Al-Dhafer, Sang Young Kim, Y. Shin, J. Kim, Shin Woo Choi","doi":"10.12790/ahm.21.0147","DOIUrl":"https://doi.org/10.12790/ahm.21.0147","url":null,"abstract":"Purpose: Failed carpal tunnel surgery poses a challenge for the attending surgeon(s). Numerous revision techniques have been reported in the literature, with evidence of long-term improvement. However, studies exploring how early could symptomatic improvement be detected are scarce. The objective of this study was to identify the speed of symptom(s) recovery after a repeated decompression technique using an open standard incision and median external nerve neurolysis with no supplemental procedures.Methods: Nine patients who underwent revision carpal tunnel surgery involving standard incision, external median neurolysis, and no supplemental techniques between June 2017 and June 2020, were included. Data regarding the preoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score, Disabilities of the Arm, Shoulder and Hand score, visual analogue score, and grip strength were collected and compared with evaluation results at 3 months postoperatively. Results: In all patients, severe adhesion of the median nerve with the surrounding soft tissue was confirmed intraoperatively. Compared with preoperative findings, 3-month evaluation of patients demonstrated a statistically significant improvement in the BCTQ symptoms score and pain score. All nine patients were satisfied with the procedure. Conclusion: Standard incision and median nerve external neurolysis can be a good option for recalcitrant carpal tunnel syndrome patient who has an adhesion of the median nerve with surrounding soft tissue.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133233140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: No consensus is made for preoperative skin antisepsis for upper extremity surgery. We aimed to determine if the use of povidone-iodine only (single regimen) instead of povidone-iodine and alcohol-chlorhexidine (triple regimen) resulted in an increased rate of surgical site infection (SSI), and to detect any associated factors that increased the infection risk.Methods: A cross-sectional, retrospective review of medical records was made for patients who underwent upper extremity surgery from March 2020 and February 2021. Either single or triple regimen was used for preoperative skin antisepsis. Rate of SSI was compared through marked elevation of C-reactive protein (CRP) at 2 weeks after surgery, superficial SSI, and deep SSI. Logistic regression analysis was performed to find the associated factors for the SSI among the evaluated parameters.Results: Among 175 patients (male, 81 and female, 94), single regimen was used in 78 patients (44.6%) and triple regimen in 97 patients (55.4%). Single regimen (odds ratio [OR], 2.425; 95% confidence interval [CI], 1.040–5.655) and surgical procedure using metal implant (OR, 3.602; 95% CI, 1.184–10.953) were significantly associated with the marked CRP elevation at 2 weeks. However, there was no difference in SSI rates between single and triple regimen. Diabetes mellitus (OR, 6.636; 95% CI, 1.259–34.969) was the only associating factor with superficial SSI through logistic regression analysis.Conclusion: Our study suggests that single regimen maintained a longer CRP elevation compared to the triple regimen, but was similarly effective in preventing SSI for upper extremity surgeries.
{"title":"The role of skin antisepsis in upper extremity surgery to reduce surgical site infection: a comparison between single and triple regimen","authors":"J. Hwang, Dong Min Lee, Yo Han Lee","doi":"10.12790/ahm.21.0151","DOIUrl":"https://doi.org/10.12790/ahm.21.0151","url":null,"abstract":"Purpose: No consensus is made for preoperative skin antisepsis for upper extremity surgery. We aimed to determine if the use of povidone-iodine only (single regimen) instead of povidone-iodine and alcohol-chlorhexidine (triple regimen) resulted in an increased rate of surgical site infection (SSI), and to detect any associated factors that increased the infection risk.Methods: A cross-sectional, retrospective review of medical records was made for patients who underwent upper extremity surgery from March 2020 and February 2021. Either single or triple regimen was used for preoperative skin antisepsis. Rate of SSI was compared through marked elevation of C-reactive protein (CRP) at 2 weeks after surgery, superficial SSI, and deep SSI. Logistic regression analysis was performed to find the associated factors for the SSI among the evaluated parameters.Results: Among 175 patients (male, 81 and female, 94), single regimen was used in 78 patients (44.6%) and triple regimen in 97 patients (55.4%). Single regimen (odds ratio [OR], 2.425; 95% confidence interval [CI], 1.040–5.655) and surgical procedure using metal implant (OR, 3.602; 95% CI, 1.184–10.953) were significantly associated with the marked CRP elevation at 2 weeks. However, there was no difference in SSI rates between single and triple regimen. Diabetes mellitus (OR, 6.636; 95% CI, 1.259–34.969) was the only associating factor with superficial SSI through logistic regression analysis.Conclusion: Our study suggests that single regimen maintained a longer CRP elevation compared to the triple regimen, but was similarly effective in preventing SSI for upper extremity surgeries.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"388 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116657686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulnar impaction syndrome (UIS), also called ulnocarpal abutment syndrome, is a degenerative condition induced by repeated load in ulnocarpal joint and is a representative cause of ulnar-sided wrist pain. Because of small, complex, and overlapping anatomy of ulnar wrist, ulnar wrist pathologies often present very similar symptoms with UIS and cause confusion in diagnosing UIS. Thus, careful history-taking, clinical examinations, and diagnostic imaging are essential to diagnosis of UIS. To appropriate and effective treatment for UIS, early surgical treatment should be considered if patients cannot reduce their wrist usage in daily living and work and have distal radioulnar instability. There are various surgical techniques for UIS. Surgeons should be deliberate in choosing them and pay attention to combined disorders around ulnar wrist for satisfactory treatment outcomes.
{"title":"Ulnar impaction syndrome: how to diagnose and treat?","authors":"H. Seok, J. W. Park, J. Kang","doi":"10.12790/ahm.21.0149","DOIUrl":"https://doi.org/10.12790/ahm.21.0149","url":null,"abstract":"Ulnar impaction syndrome (UIS), also called ulnocarpal abutment syndrome, is a degenerative condition induced by repeated load in ulnocarpal joint and is a representative cause of ulnar-sided wrist pain. Because of small, complex, and overlapping anatomy of ulnar wrist, ulnar wrist pathologies often present very similar symptoms with UIS and cause confusion in diagnosing UIS. Thus, careful history-taking, clinical examinations, and diagnostic imaging are essential to diagnosis of UIS. To appropriate and effective treatment for UIS, early surgical treatment should be considered if patients cannot reduce their wrist usage in daily living and work and have distal radioulnar instability. There are various surgical techniques for UIS. Surgeons should be deliberate in choosing them and pay attention to combined disorders around ulnar wrist for satisfactory treatment outcomes.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130024718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acro-osteolysis is a bone resorption reaction that progresses slowly in the distal phalanx of the hand and foot and is associated with various diseases. It can be classified as idiopathic or secondary. Although the mechanism of acro-osteolysis has not been fully elucidated, the chronic ischemic injury appears to have a significant effect, and bone metabolism dysregulation due to the accompanying calcinosis or peripheral neuropathy also appears to contribute. Acro-osteolysis can show various clinical and radiological features, and differential diagnosis of the underlying etiology is essential. It is a rare sporadic disease worldwide, and the authors experienced a patient with acro-osteolysis suspected of idiopathic cause in a black woman, so we report this case with literature reviews.
{"title":"Band acro-osteolysis in a black female: a case report and review of literature","authors":"J. Dan, Cheungsoo Ha, Ho-Jae Lee","doi":"10.12790/ahm.21.0140","DOIUrl":"https://doi.org/10.12790/ahm.21.0140","url":null,"abstract":"Acro-osteolysis is a bone resorption reaction that progresses slowly in the distal phalanx of the hand and foot and is associated with various diseases. It can be classified as idiopathic or secondary. Although the mechanism of acro-osteolysis has not been fully elucidated, the chronic ischemic injury appears to have a significant effect, and bone metabolism dysregulation due to the accompanying calcinosis or peripheral neuropathy also appears to contribute. Acro-osteolysis can show various clinical and radiological features, and differential diagnosis of the underlying etiology is essential. It is a rare sporadic disease worldwide, and the authors experienced a patient with acro-osteolysis suspected of idiopathic cause in a black woman, so we report this case with literature reviews.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"463 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120879127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Compartment syndrome (CS), a complication at the donor site of anterolateral thigh free flap (ALT-FF), has a low incidence. Our patient was a 26-year-old male, a professional soldier with large thigh muscles. His defect on the right ankle was reconstructed with a 30×10 cm2-sized ALT-FF. By the pinch test, the flap width was designed to be sufficient for primary closure of the donor. However, on the postoperative day 8, severe pain, tense and purulent discharge were found at the donor site. We diagnosed CS clinically, and immediately performed incision and drainage. There are various extrinsic or intrinsic factors that can influence the development of CS. Therefore, in patients with these contributing factors, such as a young man with high muscle mass, a higher level of suspicion for CS is needed. Moreover, it would be safer to design the flap width smaller than the pinch test or to cover the donor site with a skin graft.
{"title":"Compartment syndrome as a donor-site complication of anterolateral thigh free flap: a case report","authors":"B. Moon, W. Pae","doi":"10.12790/ahm.21.0095","DOIUrl":"https://doi.org/10.12790/ahm.21.0095","url":null,"abstract":"Compartment syndrome (CS), a complication at the donor site of anterolateral thigh free flap (ALT-FF), has a low incidence. Our patient was a 26-year-old male, a professional soldier with large thigh muscles. His defect on the right ankle was reconstructed with a 30×10 cm2-sized ALT-FF. By the pinch test, the flap width was designed to be sufficient for primary closure of the donor. However, on the postoperative day 8, severe pain, tense and purulent discharge were found at the donor site. We diagnosed CS clinically, and immediately performed incision and drainage. There are various extrinsic or intrinsic factors that can influence the development of CS. Therefore, in patients with these contributing factors, such as a young man with high muscle mass, a higher level of suspicion for CS is needed. Moreover, it would be safer to design the flap width smaller than the pinch test or to cover the donor site with a skin graft.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129638623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bisphosphonates have been widely used to treat osteoporosis, but atypical femoral fractures have emerged as serious complication. Similar fractures of the forearm have been reported since 2010 and retrospective studies have revealed a number of details. Clinicians should remember that bisphosphonates can affect all bony structures in the body. When misdiagnosed as an ordinary fracture and treated with surgical fixation, unexpected nonunion may occur. Therefore, I would like to share our experience from the perspective of a hand surgeon.
{"title":"Atypical forearm fractures associated with long-term bisphosphonate use: the perspective of a hand surgeon","authors":"S. Cha, H. Shin, Y. Heo, S. E. Park, S. H. Lee","doi":"10.12790/ahm.21.0098","DOIUrl":"https://doi.org/10.12790/ahm.21.0098","url":null,"abstract":"Bisphosphonates have been widely used to treat osteoporosis, but atypical femoral fractures have emerged as serious complication. Similar fractures of the forearm have been reported since 2010 and retrospective studies have revealed a number of details. Clinicians should remember that bisphosphonates can affect all bony structures in the body. When misdiagnosed as an ordinary fracture and treated with surgical fixation, unexpected nonunion may occur. Therefore, I would like to share our experience from the perspective of a hand surgeon.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122319091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contractures involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many causes of hand deformities after burn. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less is the re-contraction and growth. The foot is an ideal donor site for skin graft on the hand. In particular, the instep or the area below the malleolar is a very good donor site. First web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, skin graft, and free flap step by step according to the degree of contraction.
{"title":"Correction of Hand Deformities after Burn","authors":"Daegu Son","doi":"10.12790/ahm.21.0131","DOIUrl":"https://doi.org/10.12790/ahm.21.0131","url":null,"abstract":"Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contractures involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many causes of hand deformities after burn. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less is the re-contraction and growth. The foot is an ideal donor site for skin graft on the hand. In particular, the instep or the area below the malleolar is a very good donor site. First web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, skin graft, and free flap step by step according to the degree of contraction.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122029924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Si-Gyun Roh, Jae Young Chun, Nae-Ho Lee, J. Shin, Jong-Lim Kim
Injury of peripheral nerve may require reconstruction for motor and sensory function recovery. However, when the nerve defect is long, especially in the lower extremities, reconstruction with successful function recovery proved to be difficult. We documented a case of bilateral vascularized sural nerve graft repair of a large and long sciatic nerve defect following malignant tumor resection on posterior thigh. Although we were unable to achieve satisfactory outcomes in motor function recovery, we did accomplish some sensory function recovery.
{"title":"Reconstruction of Sciatic Nerve Using Bilateral Vascularized Sural Nerve Grafts: A Case Report","authors":"Si-Gyun Roh, Jae Young Chun, Nae-Ho Lee, J. Shin, Jong-Lim Kim","doi":"10.12790/ahm.21.0125","DOIUrl":"https://doi.org/10.12790/ahm.21.0125","url":null,"abstract":"Injury of peripheral nerve may require reconstruction for motor and sensory function recovery. However, when the nerve defect is long, especially in the lower extremities, reconstruction with successful function recovery proved to be difficult. We documented a case of bilateral vascularized sural nerve graft repair of a large and long sciatic nerve defect following malignant tumor resection on posterior thigh. Although we were unable to achieve satisfactory outcomes in motor function recovery, we did accomplish some sensory function recovery.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"22 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123616221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 53-year-old woman came to the emergency department because her right hand had been stuck in a potato-shredding machine for 30 minutes. The 2nd, 3rd, and 4th fingers were shredded into multiple slices deep into the phalangeal bone, which showed good circulation, and the wounds were cleaned with massive saline irrigation. The slices of each finger were put together to form the finger, which was sutured with nylon, and the circulation of the fingers remained good. Three weeks of gentamicin, cefazolin, and hyperbaric oxygen therapy were used for acute traumatic ischemia since the color change of fingers was observed. Six weeks of prostaglandin was used for circulation recovery. The patient was able to grasp with minimal pain and do flexion and extension, and the wound was completely healed. Radiography showed the bone union process, and the digital infrared thermal imaging test showed relatively good circulation.
{"title":"Hyperbaric Oxygen Therapy and Prostaglandin usage for Shred Injury in the Fingers: A Case Report","authors":"Hyunwoo Kim, J. Oh","doi":"10.12790/ahm.21.0132","DOIUrl":"https://doi.org/10.12790/ahm.21.0132","url":null,"abstract":"A 53-year-old woman came to the emergency department because her right hand had been stuck in a potato-shredding machine for 30 minutes. The 2nd, 3rd, and 4th fingers were shredded into multiple slices deep into the phalangeal bone, which showed good circulation, and the wounds were cleaned with massive saline irrigation. The slices of each finger were put together to form the finger, which was sutured with nylon, and the circulation of the fingers remained good. Three weeks of gentamicin, cefazolin, and hyperbaric oxygen therapy were used for acute traumatic ischemia since the color change of fingers was observed. Six weeks of prostaglandin was used for circulation recovery. The patient was able to grasp with minimal pain and do flexion and extension, and the wound was completely healed. Radiography showed the bone union process, and the digital infrared thermal imaging test showed relatively good circulation.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114770835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheungsoo Ha, Y. Kang, J. Ha, Dong Hun Han, Jun-Ku Lee, Soo-Hong Han
Schwannomas, the most frequently occurring benign tumors of the peripheral nerve sheath, generally remain as painless swellings for several years before diagnosis. Multiple schwannomas involving different nerves within the same extremity are rare. We report a rare case of a 61-year-old female who presented with multiple schwannomas in the palmar common and proper digital nerves, 15 years after the resection of a median nerve schwannoma within the same upper extremity. Using preestablished diagnostic criteria, she was diagnosed with segmental schwannomatosis. After careful surgical resection, biopsy confirmed the diagnosis and she recovered without neurological symptoms or limitations in the range of motion. Literature review revealed only four case series on segmental schwannomatosis, indicating its rarity. Postoperative sensory deficits are more likely in cases with multiple schwannomas in the common and proper digital nerves. We demonstrate that such complications can be avoided by meticulous dissection and separation of the tumors from the nerve fibers.
{"title":"Segmental Schwannomatosis in the Upper Extremity: A Case Report and Review of Literature","authors":"Cheungsoo Ha, Y. Kang, J. Ha, Dong Hun Han, Jun-Ku Lee, Soo-Hong Han","doi":"10.12790/ahm.21.0103","DOIUrl":"https://doi.org/10.12790/ahm.21.0103","url":null,"abstract":"Schwannomas, the most frequently occurring benign tumors of the peripheral nerve sheath, generally remain as painless swellings for several years before diagnosis. Multiple schwannomas involving different nerves within the same extremity are rare. We report a rare case of a 61-year-old female who presented with multiple schwannomas in the palmar common and proper digital nerves, 15 years after the resection of a median nerve schwannoma within the same upper extremity. Using preestablished diagnostic criteria, she was diagnosed with segmental schwannomatosis. After careful surgical resection, biopsy confirmed the diagnosis and she recovered without neurological symptoms or limitations in the range of motion. Literature review revealed only four case series on segmental schwannomatosis, indicating its rarity. Postoperative sensory deficits are more likely in cases with multiple schwannomas in the common and proper digital nerves. We demonstrate that such complications can be avoided by meticulous dissection and separation of the tumors from the nerve fibers.","PeriodicalId":137349,"journal":{"name":"Archives of Hand and Microsurgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125548795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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