Carpal Tunnel Syndrome with Recurrent Motor Branch Entrapment: A Case Report

Young Woo Kwon; In Cheul Choi; Hee-Kyu Kwon; Jong Woong Park

doi:10.12790/ahm.2018.23.4.267

Journal List > Arch Hand Microsurg > v.23(4) > 1108263

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kwon, Choi, Kwon, and Park: Carpal Tunnel Syndrome with Recurrent Motor Branch Entrapment: A Case Report

Hand

Archives of Hand and Microsurgery 2018; 23(4): 267-270.

Published online: 26 November 2018

DOI: https://doi.org/10.12790/ahm.2018.23.4.267

Carpal Tunnel Syndrome with Recurrent Motor Branch Entrapment: A Case Report

Young Woo Kwon¹, In Cheul Choi¹, Hee-Kyu Kwon², Jong Woong Park¹

¹Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Korea.

²Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.

Corresponding author: Jong Woong Park. Department of Orthopedic Surgery, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. TEL: +82-2-920-5924, FAX: +82-2-924-2471, ospark@korea.ac.kr

Received 3 August 2018 Revised 4 September 2018 Accepted 7 September 2018

Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve

(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

Recurrent motor branch entrapment syndrome is a compressive mononeuropathy of recurrent motor branch of median nerve. It is a rare condition as a cause of thenar muscle wasting and may have different pathogenesis. If such an anatomical variation is the cause, there is a possibility that thenar muscle atrophy remains if only the transcarpal ligament release is performed. We report a 25-year-old male patient with carpal tunnel syndrome with thenar muscle wasting 1 month ago.

Keywords: Carpal tunnel syndrome, Median nerve, Recurrent motor branch

Figures and Tables

Fig. 1

Recurrent motor branch of median nerve with origin in carpal tunnel exiting through transverse carpal ligament (dash lines) with compression of motor branch.

Fig. 2

Decompression and neurolysis of the recurrent motor branch of median nerve were performed.

Table 1

Preoperative distal motor latency and amplitude values from the abductor pollicis brevis after stimulation at the wrist

Rt: right, Lt: left, APB: abductor pollicis brevis, ADM: abductor digiti minimi.

Table 2

Postoperative distal motor latency and amplitude values from the abductor pollicis brevis after stimulation at the wrist (8 weeks after surgery)

Rt: right, APB: abductor pollicis brevis, ADM: abductor digiti minimi.

Notes

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

References

1. Bennett JB, Crouch CC. Compression syndrome of the recurrent motor branch of the median nerve. J Hand Surg Am. 1982; 7:407–409.

2. Lanz U. Anatomical variations of the median nerve in the carpal tunnel. J Hand Surg Am. 1977; 2:44–53.

3. Spinner M. Injuries to the major branches of the peripheral nerves of the forearm. Philadelphia: W. B. Saunders Company;1972.

4. Pfeiffer KM, Nigst H. [Unusual findings during surgery for carpal tunnel syndrome]. Handchirurgie. 1973; 5:99–103. German.

5. Mondelli M, Aretini A, Ginanneschi F, Padua L. Thenar motor neuropathy electrophysiological study of 28 cases. J Clin Neurophysiol. 2010; 27:344–349.

6. Rizzello G, Longo UG, Franceschi F, Martinelli N, Meloni MC, Quadrini R, et al. Compression neuropathy of the motor fibers of the median nerve at wrist level. J Chin Med Assoc. 2009; 72:268–270.

TOOLS

Similar articles