• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.79-85
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• 1991

정상대조군 20 hands와 수근관증후군환자 40 hands를 대상으로 각 1분, 2분, 5분간 수근관절굴곡 후의 신경전도속도의 변화를 측정하여 수근관증후군의 진단에 도움을 줄 수 있는지를 알아보고자 운동신경은 belly-tendon방법을, 감각신경은 역방향전도검사법을 각각 이용하여 wrist to finger segment에서 수근관절굴곡 전후의 정중신경의 SNCV와 MNDL을 측정하여 아래와 같은 결과를 얻었다. 대조군에서 수근관절굴곡 후의 신경전도속도의 변화가 있었던 경우는 감각신경에서 2 hands, 운동신경에 1 hands였으며 환자군에서는 감각신경에서 3 hands, 운동신경에서 2 hands였다. 그리고 1분, 2분 및 5분간 수근관절굴곡 후의 SNCV와 MNDL의 평균과 표준편차를 구해본 결과 대조군과 환자군에서 모두 유의한 변화가 없었다. Phlaen's wrist flexion검사에서 대조군은 5%에서 양성이었으며 환자군에서는 60%에서 양성이었다. Tinel징후는 대조군에서는 10%에서 양성이었으며 환자군에서는 33%에서 양성이었다.

• 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.