The persistent median artery can be a rare cause of carpal tunnel syndrome. We present an anatomic variant of this artery. A 47-year-old female patient with bilateral carpal tunnel syndrome was found to have bilateral patent, functional persistent median arteries (PMA) upon operative exploration. Unlike previous reports, the PMAs were not located dorsal to the flexor retinaculum (FR). Rather, the PMAs were interposed between the palmar aponeurosis and the FR. Accompanied by two venae comitantes, the aberrant arteries were positioned directly in line with our carpal tunnel incisions on both hands. Although rare, it is important for the surgeon to be aware of this anatomic variant to prevent inadvertent injury to what may be an important vascular supply to the distal median nerve.
A nonspecific soft tissue mass of the hand can be difficult to diagnose due to the multitude of possible etiologies. In this case, we discuss our experience in diagnosing and treating intravascular papillary endothelial hyperplasia, or Masson's tumor, of the hand. The wide range of differential diagnoses and the morphological resemblance to angiosarcoma make Masson's tumor an important clinical entity to understand. The purpose of this study is to familiarize the reader with the appropriate diagnostic and treatment modalities that allow the clinician to recognize Masson's tumor, differentiate it from similar clinical entities, and institute the appropriate management regimen.
Aberrant accessory muscles are rare entities in the hand. The extensor digitorum brevis manus (EDBM) muscle is amongst them and may be seen in association with dorsal ganglion cysts. Distinguishing an EDBM muscle is relevant in the diagnostic consideration of a dorsal ganglion in order to facilitate and guide its proper treatment. To date, there have been only few reports of an EDBM in association with a dorsal ganglion cyst. We report our experience with an incidental intraoperative finding of an intramuscular EDBM dorsal ganglion cyst and follow with a literature review and guide to management.
Figure 1. Lower extremity defect status post serial debridement. Exposed hardware can be seen.
DESCRIPTIONA 39-year-old male with an open wound of the left lower extremity complicated by exposed hardware following open reduction and internal fixation of a tibial plateau fracture.
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