No abstract

In this prospective study, 56 women (2.3%) of 2,358 (47% nulliparous and 53% multiparous) delivered during a 12-month period at the Department of Obstetrics and Gynecology, Malmö General Hospital, had symptoms of carpal tunnel syndrome during pregnancy. All (33 nulliparous and 23 multiparous women) were examined, at the outpatient's maternity care unit and within 4-5 weeks from the time of debut of symptoms, by a specialist in hand surgery. At that time the most common symptoms were paresthesia and nocturnal pain. Twenty-nine had signs of reduced sensibility and 14 of them had a positive two-point discrimination test. All had generalized edema. Conservative treatment with splinting of the wrist at night made 46 out of 56 symptom-free. Of the remaining 10 women, 3 had to be operated on, whereas 7 received only conservative treatment, as the expected time for parturition was very close. One of them had to be operated on after delivery. In conclusion, carpal tunnel syndrome during pregnancy is most common in primiparas with generalized edema. Conservative treatment is sufficient for symptom relief in most women (80%) but a few cases need operative intervention to abolish the severe pain and to avoid disturbances of hand function.

Two cases of ulnar tunnel syndrome at the wrist are described. In both cases an anomalous hypothenar muscle, flexor digiti minimi brevis accessorius, was in part the causative factor. Contributing to the symptoms of nerve compression was swelling associated with rheumatoid disease and Colles' fracture, respectively. Decompression of the nerve including subtotal removal of the anomalous muscle effected complete recovery. Its phylogeny, morphology and clinical significance are discussed in relation to previously described anomalies of the hypothenar muscles.

In the present study radiological evaluation of 45 cases of Bennett's fracture reveals that different types of fracture dislocations correlate with late and typical deformities of the metacarpal joint surface. Functional results with special reference to treatment by closed reduction and percutaneous pinning show that this method was successful in most cases treated (92%). It is concluded that percutaneous pinning offers a simple and reliable way of fixation which eliminates the need for X-rays during the healing period. Untoward effects on the joints caused by the pins were not observed and the incidence of secondary arthrosis was not higher than reported for other methods of internal fixation. 4 11 30 Scand J Plast Reconsfr Surg 5 Scand J Plast Surg Recontr Surg Hand Surg Downloaded from informahealthcare.com by University of Toronto on 11/19/14 For personal use only. 26, 3. ThorCn, L. 1956. A new method of extension treatment in Bennett's fracture. Acta Chir Scand 110, 485. Scand J Plast Reconstr Surg 5 Scand J Plast Surg Recontr Surg Hand Surg Downloaded from informahealthcare.com by University of Toronto on 11/19/14For personal use only.

14 patients with painful neuroma, skin hyperesthesia or neuralgic rest pain were followed up (mean 20 months) after excision of skin and scar, neurolysis and coverage with pedicled or free flaps. Painful neuroma had improved in 3 of 7 patients. Skin hyperesthesia had been eliminated in 8 of 11 patients, and had improved in 3. Neuralgic rest pain had been eliminated in 5 of 6 patients, and was partially relieved in one. It is concluded that painful neuroma in continuity is not relieved by flap coverage, whereas skin hyperesthesia and neuralgic rest pain are appropriate for this type of treatment.