Can simple release relieve symptoms of carpal tunnel syndrome caused by a persistent median artery? Clinical experience.
BACKGROUND
Compression of the median nerve at the wrist by a persistent median artery is one of the uncommon reasons for carpal tunnel syndrome. Most of the studies in the literature deal with thrombosed persistent median artery.


METHODS
In this study, we present surgical treatment of four carpal tunnel syndromes, which had persistent median arteries. The mean age of the patients was 51 years. All four median arteries were patent and only transverse carpal ligament releases were performed using a standard anterior open approach for decompression of the carpal tunnel. Neither ligation nor transposition of the arteries was done.


RESULTS
All patients became symptom free after a few weeks. Only one patient had a slight recurrence 13 months postoperatively. Splint use and modification of her activities reduced her disturbance, and no further treatment was applied.


CONCLUSIONS
If the patient has no additional anomaly, our clinical experiences lead us not to advise resection or transposition because simple release of the transverse carpal ligament can relieve symptoms.
Bilgin
S Sinan
SS
Department of Orthopaedic Surgery, Division of Hand Surgery, University of Ankara, Guvenlik Cad. 19/18, 06540, Kavaklidere, Ankara, Turkey. ssbilgin@hotmail.com
Olcay
S Eren
SE
Derincek
Alihan
A
Adiyaman
Sinan
S
Demirtas
A Mehmet
AM
D001158:Arteries / Q000002:abnormalities / Q000196:embryology; D018376:Cardiovascular Abnormalities / Q000150:complications*; D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D016896:Treatment Outcome; D014953:Wrist / Q000098:blood supply