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Formation of a Subcutaneous Amputation Neuroma after Incomplete Endoscopic Carpal Tunnel Release Resulting in Complex Regional Pain Syndrome:A Case Report Satoru SHIMIZU 1 , Shigeyuki OSAWA 1 , Mitsuru DAN 1 , Osamu TANAKA 2 , Takahiro MOCHIZUKI 1 , Mitsuru NEMOTO 3 , Hidehiro OKA 4,5 , Toshihiro KUMABE 5 1Department of Neurosurgery, Yokohama Brain and Spine Center 2Clinical Laboratory, Yokohama Brain and Spine Center 3Department of Plastic and Aesthetic Surgery, Kitasato University School of Medicine 4Department of Neurosurgery, Kitasato University Medical Center 5Department of Neurosurgery, Kitasato University School of Medicine Keyword: carpal tunnel syndrome , complex regional pain syndrome , complication , endoscopic carpal tunnel release pp.1093-1101
Published Date 2018/12/10
DOI https://doi.org/10.11477/mf.1436203874
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 This 64-year-old woman had undergone endoscopic carpal tunnel release(ECTR)for right carpal tunnel syndrome 16 months earlier. Thereafter, she reported persistent dysesthesia in the thumb and index finger, developed burning pain in the middle and ring finger, paleness, coldness, and edema of the hand, a decreased range in hand motion, and a painful subcutaneous nodule just distal to the portal in the forearm. Based on physical, radiological, and electrophysiological studies, the diagnosis was incomplete carpal tunnel release associated with complex regional pain syndrome(CRPS). At open revision surgery, the carpal tunnel was released completely and the nodule was removed. Symptoms other than hypesthesia in the middle and ring fingers improved. Pathologically, the nodule was an amputation neuroma. Her CRPS was attributed to ECTR complications;i.e., persistence of median nerve compression and the formation of an amputation neuroma in the palmar cutaneous branch of the ulnar nerve at the portal. Surgeons must be aware that ECTR, a less invasive technique, may result in serious complications including CRPS.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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