CARPAL TUNEL SYNDROME IN TWO PATIENTS WITH BIFID MEDIAN NERVE

Diana-Andreea Bonto1, Andra-Elena Martin2, E. M. Popescu 1, Zamfirescu 1,2

1The University of Medicine and Pharmacy „Carol Davila”, Bucharest, Romania
2Plastic Surgery and Reconstructive Microsurgery Clinic, Bucharest, Romania


Corresponding author: Diana-AndreeaBonto
Phone no. 0040766485119
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Abstract

The most frequent type of entrapment neuropathy is the carpal tunnel syndrome, represented by a constellation of signs and symptoms in which no test absolutely confirms the diagnosis. The bifid median nerve is an anatomic variation that can be associated with this syndrome and the surgeon must be aware of this condition preoperatively in order to plan correctly the surgical approach. Ultrasonography and magnetic resonance imaging can be successfully used for the detection of the anatomic variation of the median nerve, for the complete evaluation of the carpal tunnel soft tissue and its anatomic structures in order to obtain better results. We present two cases of unilateral carpal tunnel syndrome with bifid median nerve diagnosed preoperatively by means of ultrasonography and the good outcome after the open decompression procedure. The existence of anatomic variation of the median nerve along with other possible pathologies in the carpal tunnel determine us to select the open procedure despite the existence of the endoscopic approach in order to provide better visualization in the surgical field and correct identification of the anatomic structures.

Keywords: carpal tunnel syndrome, bifid median nerve, decompression

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