Carpal Tunnel Syndrome Caused by Persistent Median Artery and Bifid Median Nerve in an Adolescent

Sang-Uk Lee; Hyun Woo Lee; Sun Young Joo

doi:10.4055/jkoa.2019.54.5.452

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Lee, Lee, and Joo: Carpal Tunnel Syndrome Caused by Persistent Median Artery and Bifid Median Nerve in an Adolescent

Case Report

Journal of the Korean Orthopaedic Association 2019; 54(5): 452-456.

Published online: 30 October 2019

DOI: https://doi.org/10.4055/jkoa.2019.54.5.452

Carpal Tunnel Syndrome Caused by Persistent Median Artery and Bifid Median Nerve in an Adolescent

Sang-Uk Lee, M.D., Hyun Woo Lee, M.D., Sun Young Joo, M.D.

Department of Orthopedic Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.

Correspondence to: Sun Young Joo, M.D. Department of Orthopedic Surgery, The Catholic University of Korea, Incheon St. Mary's Hospital, 56 Dongsu-ro, Bupyeon-gu, Incheon 21431, Korea. TEL: +82-32-280-5881, FAX: +82-32-280-6538, sjoo@catholic.ac.kr

Received 30 December 2018 Revised 27 January 2019 Accepted 28 January 2019

The Korean Orthopaedic Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Carpal tunnel syndrome is rare in children. When it does occur in children, the most common causes reported are mucopolysaccharidosis and mucolipidosis. The median artery is a transitory vessel that develops from the axillary artery in early embryonic life and does not normally survive until postfetal life. In a small percentage of individuals, however, it persists into adulthood and is frequently accompanied by a bifid median nerve. A persistent median artery can be a cause of carpal tunnel syndrome in adults, but it is extremely rare in children and adolescents. This paper reports a case of a carpal tunnel syndrome caused by a persistent median artery and bifid median nerve in a 13-year-old girl.

Keywords: carpal tunnel syndrome, arteries, median nerve, adolescent

Figures and Tables

Figure 1

Photograph of both hands demonstrate thenar muscle atrophy of the right hand.

Figure 2

(A) Sonography of the right wrist shows bifid median nerve (solid arrows) and persistent median artery (open arrow). (B) Axial T2-weighted magnetic resonance imaging shows the ulnar trunk (open arrow) and radial trunk (open arrow) of the bifid median nerve and persistent median artery (solid arrow).

Figure 3

(A) Intraoperative photograph of the volar wrist shows transverse carpal ligament. (B) After carpal tunnel release, the bifid median nerves and associated median vessels were apparent.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose

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ORCID iDs: Sun Young Joo
https://orcid.org/0000-0002-0322-1816
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