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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 636-641
DOI: 10.1055/s-0041-1731361
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Prevalence of Anatomical Variations in Patients with Carpal Tunnel Syndrome Undergoing Classical Open Carpal Tunnel Release

Article in several languages: português | English
Victor Spirandelli Pimentel 
1   Faculdade de Medicina, Universidade de Taubaté (UNITAU), Taubaté, SP, Brasil
,
Bruna Borsari Artoni 
2   Curso de Medicina, Faculdade de Medicina, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brasil
,
Flavio Faloppa 
3   Departamento de Ortopedia e Traumatologia, Disciplina de Cirurgia da Mão e Membro Superior, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
,
João Carlos Belloti 
3   Departamento de Ortopedia e Traumatologia, Disciplina de Cirurgia da Mão e Membro Superior, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
,
Marcel Jun Sugawara Tamaoki 
3   Departamento de Ortopedia e Traumatologia, Disciplina de Cirurgia da Mão e Membro Superior, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
,
Benedito Felipe Rabay Pimentel 
1   Faculdade de Medicina, Universidade de Taubaté (UNITAU), Taubaté, SP, Brasil
4   Serviço de Ortopedia e Traumatologia, Hospital Municipal Universitário de Taubaté (H-MUT), Taubaté, SP, Brasil
5   Serviço de Ortopedia e Traumatologia, Hospital Regional do Vale do Paraíba (HRVP), Complexo Hospitalar do Vale do Paraíba, Taubaté, SP, Brasil
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Abstract

Objective To evaluate the prevalence of anatomical variations encountered in patients with carpal tunnel syndrome who underwent carpal tunnel classical open release.

Methods A total of 115 patients with a high probability of clinical diagnosis for carpal tunnel syndrome and indication for surgical treatment were included. These patients underwent electroneuromyography and ultrasound for diagnostic confirmation. They underwent surgical treatment by carpal tunnel classical open release, in which a complete inventory of the surgical wound was performed in the search and visualization of anatomical variations intra- and extra-carpal tunnel.

Results The total prevalence of anatomical variations intra- and extra-carpal tunnel found in this study was 63.5% (95% confidence interval [CI]: 54.5–72.4). The prevalence of the carpal transverse muscle was 57.4% (95% CI: 47.8–66.6%), of the bifid median nerve associated with the persistent median artery was 1.7% (95% CI: 0.0–4.2%), and the median bifid nerve associated with the persistent median artery and the transverse carpal muscle was 1.7% (95% CI: 0.0–4.2%).

Conclusion The most prevalent extra-carpal tunnel anatomical variation was carpal transverse muscle. The most prevalent intra-carpal tunnel anatomical variation was median bifid nerve associated with the persistent median artery. The surgical finding of an extra-carpal tunnel anatomical variation, such as the transverse carpal muscle, may indicate the presence of other associated carpal intra tunnel anatomical variations, such as the bifid median nerve, persistent median artery, and anatomical variations of the recurrent median nerve branch.

Keywords

carpal tunnel syndrome - median nerve - surgical procedures - prevalence

Financial Support

There was no financial support from public, commercial, or non-profit sources.


Note

Study performed at Hospital Regional do Vale do Paraíba (HRVP), Complexo Hospitalar do Vale do Paraíba, Faculdade de Medicina, Universidade de Taubaté (UNITAU), Taubaté, SP, Brazil.




Publication History

Received: 18 October 2020

Accepted: 08 January 2021

Article published online:
01 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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