• Archives of Plastic Surgery
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• 제49권6호
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• pp.750-754
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• 2022

Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

• 대한정형외과학회지
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• 제54권5호
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• pp.452-456
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• 2019

소아 및 청소년에서 수근관 증후군은 드물며 대부분 점액다당류증과 같은 대사성 질환에 연관되어 나타난다. 정중동맥은 태생기 동맥으로 정상적으로는 태생기에 사라지나 간혹 퇴화되지 않고 지속적으로 남아 있기도 하며, 이분정중신경이 흔히 동반되기도 한다. 이는 성인에서 수근관 증후군을 일으키는 원인 중 하나로 알려져 있으나 소아 및 청소년에서는 매우 드물게 보고되고 있다. 저자들은 건강한 13세 여아에서 정중동맥과 이분정중신경에 의한 수근관 증후군을 경험하였기에 문헌고찰과 함께 보고하고자 한다.