Acute Carpal Tunnel Syndrome After Canine Bite

Brown, Bryan D.; Roth, Travis S.; Gasner, Kurt A.

doi:10.5435/jaaosglobal-d-17-00069

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Stannard states that it is important to make a skin incision about 2 cm proximal to the wrist skin line to obtain a sufficient surgical field. In addition, it is necessary to prevent the carpal tunnel pressure from rising again by removing the tissue that has grown in the carpal tunnel [ 10 , 11 ]. In our case, a wide skin incision was made to the proximal wrist joint, and a sufficient incision was made to the fascia of the forearm to decompress the nerve and remove the enlarged synovium as much as possible.…”

Section: Discussionmentioning

confidence: 99%

A Case of Atraumatic Acute Carpal Tunnel Syndrome Requiring Emergency Surgery

Ohuchi,

Tomioka,

Miyakoshi

2023

Cureus

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Acute carpal tunnel syndrome (ACTS) is an urgent condition in which symptoms progress rapidly on an hourly basis, and emergency surgery may be required to treat it. ACTS often occurs after a traumatic event such as a fracture of the distal radius, and rarely occurs non-traumatically. We present a case of a 60-year-old male with ACTS secondary to acute synovitis due to rheumatoid arthritis. The patient complained of strong numbness from the thumb to the ring finger and pain in the palm, and he was unable to actively flex or extend his fingers. In addition, severe tenderness was observed in the palm; on the contralateral side, no obvious tenderness of the forearm and wrist joint was observed. Due to the intolerable pain and numbness, ACTS was suspected. Internal pressure from the forearm to the palm was measured, and it was found that the internal pressure of the carpal tunnel was elevated at 150 mmHg. Based on these findings, non-traumatic ACTS was diagnosed, and emergency surgery was performed. The transverse carpal ligament was exposed, an incision was made from the distal end, and the proximal part was fully incised to the forearm fascia so that the carpal tunnel was completely released. The synovial membranes around the median nerve were peeled off, confirming that the nerve had been loosened sufficiently. After the operation, finger pain and numbness improved dramatically from the day after surgery. Proper diagnosis and prompt treatment with surgical median nerve decompression are crucial for good functional recovery in these patients.

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Section: Discussionmentioning

confidence: 99%

A Case of Atraumatic Acute Carpal Tunnel Syndrome Requiring Emergency Surgery

Ohuchi,

Tomioka,

Miyakoshi

2023

Cureus

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“…Deep space infections and pyogenic flexor tenosynovitis (PFT) usually occur after a puncture wound. Acute carpal tunnel syndrome is defined by an increase in pressure exceeding 20–30 mmHg within the carpal tunnel, which compromises epineurial blood flow and causes a progressive worsening of median nerve symptoms [ 3 ]. Acute carpal tunnel syndrome secondary to pyogenic infection is a rare entity that has previously been reported in patients with animal bites, penetrating trauma, and indwelling central venous catheters [ 3 , 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Acute carpal tunnel syndrome is defined by an increase in pressure exceeding 20–30 mmHg within the carpal tunnel, which compromises epineurial blood flow and causes a progressive worsening of median nerve symptoms [ 3 ]. Acute carpal tunnel syndrome secondary to pyogenic infection is a rare entity that has previously been reported in patients with animal bites, penetrating trauma, and indwelling central venous catheters [ 3 , 4 , 5 ]. We theorize that maintaining different hand grips on climbing holds can generate significant shearing forces at the fingertips and palm and may lead to abrasions and cuts.…”

Section: Discussionmentioning

confidence: 99%

Acute Septic Carpal Tunnel Syndrome in a Rock Climber

Zbeda

Rabinovich

Vialonga

et al. 2021

JOCR

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Introduction: Rock climbing is an increasingly popular sport in the United States. Acute and chronic upper extremity injuries related to rock climbing are frequently reported and include flexor pulley ruptures and hamate stress fractures. Deep space hand infections after indoor rock climbing are a sport-related pathology that has yet to be reported. Our purpose is to describe an acute septic carpal tunnel syndrome following rock climbing at an indoor climbing gym in a patient who required urgent irrigation and debridement. Case Report: A 33-year-old Caucasian male presented with an acute septic carpal tunnel syndrome 4 days after rock climbing at an indoor gym. On physical examination, he exhibited numbness over the fingers, significant tenderness to palpation, and pain with passive range of motion. His inflammatory markers were markedly elevated and deep space hand infection was confirmed with computed tomography scans. The patient was taken for urgent exploration, irrigation and debridement, and carpal tunnel release. Conclusion: We theorize that the patient had an abrasion on the finger or palm that created an entryway for a pathogen. We are unaware of another report of a deep space hand infection associated with rock climbing activities. This case report will hopefully spread awareness of this clinical entity to improve evaluation and prevention of hand infections in rock climbers, as well as providing guidelines for appropriate and timely treatment of the condition. Keywords: Hand surgery, infection, rock climbing.

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“…Carpal tunnel syndrome resulting from animal or insect bites has only been reported in a handful of cases and has not previously been described secondary to acute generalised exanthematous pustulosis (AGEP) 1–4. Although insect bites can cause AGEP, it has never been reported to be associated with bilateral carpal tunnel syndrome.…”

Section: Introductionmentioning

confidence: 99%

Acute generalised exanthematous pustulosis: an unusual cause of carpal tunnel syndrome

Lim

Wong

2021

BMJ Case Rep

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A 65-year-old man presented with generalised erythematous pustular rash following an insect bite. He was initially treated with antibiotics for presumed cellulitis. He subsequently developed bilateral carpal tunnel syndrome. Skin biopsy confirmed a diagnosis of acute generalised exanthematous pustulosis, which resolved with oral prednisolone. He also had steroid injections for his bilateral carpal tunnel syndrome and this recovered uneventfully. Clinical presentation, histological assessment and EuroSCAR criteria were key to the diagnosis and management of this case.

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Acute Carpal Tunnel Syndrome After Canine Bite

Cited by 3 publications

References 8 publications

A Case of Atraumatic Acute Carpal Tunnel Syndrome Requiring Emergency Surgery

A Case of Atraumatic Acute Carpal Tunnel Syndrome Requiring Emergency Surgery

Acute Septic Carpal Tunnel Syndrome in a Rock Climber

Acute generalised exanthematous pustulosis: an unusual cause of carpal tunnel syndrome

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