1,720,986 research outputs found
Use of vein grafts in emergency in peripheral nerve defect.
No full textPeripheral nerve defects represent a frequent lesion in emergency. The vein graft is the alternative to nerve graft in cases where the nerve defect does not allow a direct approximation. Our experience on the use of venous graft has brought about excellent functional results that, together with a simple execution of the methodology, are at the bottom of our study. During the last 6 months we have treated 3 cases of peripheral nerve defect with nerve gap >2 cm; 1 lesion of ulnar nerve, 1 lesion of median nerve treated with vein graft and in 1 case an association of the median and ulnar nerve treated with reversed vein graft. An immediate resolution of the pain was observed in all patients already during the first 36/48 hrs. The clinical and electrophysiological evaluations at 3 and 6 months have demonstrated encouraging data regarding functional reparation and re-innervation. Even in consideration of the limited number of cases, comparison with data related to the autologous nerve graft shows a slightly slower recovery, but certainly overlapping to the classical methodology; moreover, excellent clinical results appear from the use of reversed vein graft. The advantage of vein grafts are multiple. There is an overlapping of the functional recovery, that represents the condition sine qua non of each new surgical experimental procedure. The simplicity of the technical execution and the possibility to cover missing nerves without sensory damage is advantageous both for the patient and for the structure, reducing operating time and related costs
Clinical and electrophysiological comparison of different methods of soft tissue coverage of the median nerve in recurrent carpal tunnel syndrome
No full textClinical and Electrophysiological Comparison of Different Methods of Soft Tissue Coverage of the Median Nerve in Recurrent Carpal Tunnel Syndrome To the Editor: We would like to report our clinical and ultrasonographic experience in decreasing the pillar pain rate and symptoms after carpal tunnel decompression. Recently, Stu_tz et al. (4) evaluated the clinical and electrophysiological results in 26 patients treated with either a hypothenar fat flap or a synovial flap to prevent recurrent scar compression of the median nerve after previously failed carpal tunnel decompression. They obtained reduction rates of brachial nocturnal pain and pillar pain and concluded that coverage by an ulnar-based hypo - thenar fat flap seemed to produce superior results (4)
Neuritis of the sensory branch of the radial nerve. Wartemberg's syndrome. A case report.
No full textWartembergs syndrome is an entrapment of the sensory branch of the radial nerve in the forearm. It is not mentioned with the other peripheral nerve entrapments and it is very rare. Wartemberg's syndrome is too often misdiagnosed as the De Quervain's disease or is not diagnosed at all. The Authors report their experience with a case surgically treated
Ulnar Artery Thrombosis and Nerve Entrapment at Guyon's Canal: Our Diagnostic and Therapeutic Algorithm
No full textHypothenar hammer syndrome is a rare condition of ulnar artery aneurysm or thrombosis, which can be associated with a neuropathy of the ulnar nerve. There is no agreement regarding an optimal diagnosis and treatment for this syndrome. Most authors suggest angiography as the gold standard for diagnosis and recommend observation for the thrombotic type, and reconstructive surgery for the aneurysmal type. We report here our diagnostic and therapeutic algorithm, reviewing 9 patients with ulnar artery thrombosis and nerve entrapment at Guyon's canal; and an evaluation of the type of management including: anamnesis, diagnostic tests, and reconstructive surgery. We consider resection of the arterial thrombotic segment as the treatment of choice, due to the fact that ulnar arterial thrombosis can induce severe chronic inflammation into Guyon's canal and ulnar nerve sufferance. Therefore, we propose a planned approach, including 3 steps: clinical evaluation with Tinel and Allen's tests; magnetic resonance and ultrasound images; ulnar nerve decompression and arterial reconstruction. We believe that this practice is important for the early therapy of ulnar arterio-neuropathy in affected patients
[Post-traumatic subperiosteal chondroma of the hand. Clinical case].
No full textThe authors report a case of rapidly developing periosteal chondroma of the fifth metacarpal. No erosion of the bone cortex could be observed radiographically. The development of the tumor appears to follow a violent trauma without skeletal lesions occurred seven months before
Cutaneous Merkel cell carcinoma: case report
No full textMerkel cell carcinoma is an unusual cutaneous malignancy with a propensity for spreading to regional lymph nodes, with recurrence at original site or/and in lymph node. Occurring most often on the head and neck of the elderly patients. Complete surgical resection is the mainstay of treatment of the primary tumor. A case is here described of an old patient with more than one local relapse and in regional lymph nodes too, complete surgical resected, actually in good state of health, treated with radiotherapy
Ulnar Artery Thrombosis and Nerve Entrapment at Guyon's Canal: Our Diagnostic and Therapeutic Algorithm
No full textHypothenar hammer syndrome is a rare condition of ulnar artery aneurysm or thrombosis, which can be associated with a neuropathy of the ulnar nerve. There is no agreement regarding an optimal diagnosis and treatment for this syndrome. Most authors suggest angiography as the gold standard for diagnosis and recommend observation for the thrombotic type, and reconstructive surgery for the aneurysmal type. We report here our diagnostic and therapeutic algorithm, reviewing 9 patients with ulnar artery thrombosis and nerve entrapment at Guyon's canal; and an evaluation of the type of management including: anamnesis, diagnostic tests, and reconstructive surgery. We consider resection of the arterial thrombotic segment as the treatment of choice, due to the fact that ulnar arterial thrombosis can induce severe chronic inflammation into Guyon's canal and ulnar nerve sufferance. Therefore, we propose a planned approach, including 3 steps: clinical evaluation with Tinel and Allen's tests; magnetic resonance and ultrasound images; ulnar nerve decompression and arterial reconstruction. We believe that this practice is important for the early therapy of ulnar arterio-neuropathy in affected patients
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