Low Motor Ulnar Nerve Palsy Caused by a Traumatic Pseudoaneurysm of the Ulnar Artery

Pediatric ulnar artery pseudoaneurysm of the wrist after glass laceration: A case report and systematic review of the literature

“…From 192 potential articles found in the literature, 34 articles fulfilled the study eligibility criteria (Table 1). The pathophysiologic mechanism described for aneurysm of the ulnar artery was traumatic or nontraumatic (Al‐Omran, 2007; Amjad et al, 2010; Belyayev et al, 2015; Boretto et al, 2014; Cardinale, Posner, & Abernathy, 2018; Erdil et al, 2010; Erdoes & Brown, 1995; Gimenez et al, 2009; Green, 1973; Higgs & Weeks, 1993; Hurst et al, 2014; Kehara et al, 2018; Komorowska‐Timek et al, 2004; Lee et al, 2010; Lee et al, 2017; Milling & Kinmonth, 1977; Nade, 1972; Nough et al, 2014; Offer & Sully, 1999; Pin et al, 2018; Plant & Scilley, 2007; Polytarchou et al, 2016; Poonai et al, 2011; Rothkopf et al, 1990; Ryu & Kim, 2010; Sekino et al, 2005; Shaerf et al, 2019; Stalder et al, 2016; Thio, 1972; Torres‐Blanco et al, 2015; Vancabeke et al, 1999; Wang et al, 1998; Witt et al, 2003; Woodley‐Cook et al, 2015). Nine authors presented cases of ulnar artery aneurysms in pediatric patients (Al‐Omran, 2007; Amjad et al, 2010; Green, 1973; Nade, 1972; Offer & Sully, 1999; Poonai et al, 2011; Rothkopf et al, 1990; Stalder et al, 2016; Witt et al, 2003).…”

“…The differential diagnosis for a wrist mass is broad. Additional diagnoses to consider include hemangioma, ganglion cyst, seroma, hematoma, neurilemoma, arteriovenous fistula, epidermoid inclusion cyst, sarcoma, and Kawasaki disease (Amjad et al, 2010; Boretto et al, 2014; Green, 1973; Rothkopf et al, 1990). Ulnar artery aneurysm classically presents with a soft, pulsating mass that slowly enlarges on the volar surface of the wrist in the hypothenar region (Gimenez et al, 2009; Offer & Sully, 1999; Rothkopf et al, 1990; Stalder et al, 2016).…”

“…This diagnostic imaging is the best initial test when a wrist mass is present for multiple reasons: its low cost, lack of radiation exposure to the child, noninvasive nature, and ability to differentiate between many pathologies (Al‐Omran, 2007). On ultrasound, the aneurysm will appear as an anechoic, ovoid structure (Boretto et al, 2014). The image can look similar to a seroma, hematoma, or cystic lesion.…”

“…Surgical options for ulnar artery aneurysm include ligation, ligation and resection, excision with end‐to‐end anastomosis, or excision with placement of an interposition vein or arterial graft (Amjad et al, 2010; Boretto et al, 2014; Erdoes & Brown, 1995; Esposito et al, 2006; Hurst et al, 2014; McClinton, 2011; Milling & Kinmonth, 1977; Rothkopf et al, 1990; Sarkar et al, 1991; Stalder et al, 2016; Wang et al, 1998). Beyond resection, few alternatives are discussed in the literature.…”

“…Once the patient has developed hand dominance, they are more likely to suffer an aneurysm in their dominant hand due to increased exposure to trauma (Rothkopf, Bryan, Cuadros, & May Jr, 1990). A true aneurysm is defined as a partial disruption of the arterial wall, leading to dilatation of the vessel (Boretto, Gallucci, & De Carli, 2014). A false aneurysm is a complete disruption of the arterial wall (full thickness), resulting in an extra‐arterial hematoma, that is surrounded by fibrous tissue and remains in continuity with arterial flow (Boretto et al, 2014; Rothkopf et al, 1990).…”