title: Nerve compression syndromes of the hand and forearm associated with tumours of non-neural origin and tumour-like lesions.
abstract: Nerve compression syndromes caused by non-neural tumours or tumour-like lesions are rare. We retrospectively reviewed 541 consecutive patients operated on by the same surgeon to study nerve compression syndromes in the forearm and hand. There were 414 due to nerve compression and 127 caused by tumours. Twenty-two patients showed compression neuropathy associated with 17 tumours and six tumour-like lesions, with 13 different pathological types. The most common types were fatty and vascular tumours. Twenty-one tumours were extraneural and one was intraneural. The median nerve was affected in nine cases, the ulnar nerve or the dorsal sensory branch of the ulnar nerve in five cases, the posterior interosseous nerve or the superficial radial branch in four cases and the common digital nerves in two cases. There was a concomitant involvement of the median and ulnar nerves in two other patients. Clinically, there were eight different compression neuropathies, of which the most frequent was the carpal tunnel syndrome. The postoperative histology was consistent with preoperative magnetic resonance imaging findings in the vascular and fatty tumours. Pain disappeared completely in 15 out of 16 patients with preoperative pain. All patients had preoperative paraesthesia, which persisted after tumour excision in three patients: attenuated in two patients and unchanged in one. In three patients, we did not observe any change in paresis or amyotrophy. The mean postoperative follow-up was 31 months, without tumour recurrence. The quick Disabilities of the Arm, Shoulder and Hand (DASH) score went from 49.9 points preoperatively to 10.2 points after surgery.
authors.affiliation: Department of Trauma and Orthopaedic Surgery (Hand Surgery and Microsurgery Unit), Miguel Servet University Hospital, 50009 Zaragoza, Spain. Electronic address: gmartinezvillen@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Martínez-Villén
authors.affiliation: Department of Trauma and Orthopaedic Surgery (Hand Surgery and Microsurgery Unit), Miguel Servet University Hospital, 50009 Zaragoza, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Badiola
authors.affiliation: Department of Pathology, Miguel Servet University Hospital, 50009 Zaragoza, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Alvarez-Alegret
authors.affiliation: Department of Radiology, Miguel Servet University Hospital, 50009 Zaragoza, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Mayayo
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D017769:Ulnar Nerve Compression Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult
keywords: Forearm; Hand; Nerve compression; Surgery; Tumours