RESUMO
We describe the case of an original insertion and course of the abductor digiti minimi muscle on the medial part of the palmaris longus tendon. The anomalous muscle was only present on the left side. Various studies have reported the frequency of anomalous muscles in approximately 22 to 35% of hands and it was in majority an anomalous abductor digiti minimi muscle. The knowledge of this original insertion is important because it can sometimes be correlated with ulnar nerve compression at Guyon's canal. But Guyon's canal syndrome is less common than carpal tunnel syndrome, and the incidence of ulnar nerve compression in relation with anomalous muscle is approximately 2.9% of cases. It is possible to diagnose the anomalous muscle through ultrasound or MRI. This variation should be taken into consideration by surgeons during surgical procedures for ulnar nerve decompression at Guyon's canal and when performing anteromedial approach to the wrist between flexors tendons and ulnar bundle.
Assuntos
Mãos/anatomia & histologia , Músculo Esquelético/anatomia & histologia , Síndromes de Compressão do Nervo Ulnar/etiologia , Punho/anatomia & histologia , Cadáver , Mãos/embriologia , Humanos , Complicações Intraoperatórias/prevenção & controle , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/embriologia , Síndromes de Compressão do Nervo Ulnar/diagnóstico por imagem , Síndromes de Compressão do Nervo Ulnar/patologia , Síndromes de Compressão do Nervo Ulnar/cirurgia , Ultrassonografia , Punho/embriologiaRESUMO
The purpose of this study was to assess the simple decompression as surgical treatment for ulnar tunnel syndrome at elbow. The review was in eight patients with a total of ten cases. The electromyography and neuroconduction study was altered in all cases. The classification according McGowan was: 40 percent of cases in grade I, 40 percent grade IIA and 20 percent grade IIB. In the 63 percent of cases a concomitant carpal tunnel syndrome was treated surgically. In all cases, a compressive Osbornes arcade was observed. The follow up are 3,8 months with an 100 percent of excellent (complete relief of symptoms) and good (minimal residual symptoms) results. This review shows that the simple decompression is a proved and reproducible surgical technique. This technique can be the first option for the surgical treatment of the ulnar tunnel syndrome.
Se presenta trabajo prospectivo sobre la descompresión simple como tratamiento quirúrgico del síndrome de compresión del nervio ulnar en el codo. Se revisa una serie de 8 pacientes y 10 codos operados. Hubo electromiografía alterada en todos los casos. Se clasificó preoperatoriamente según McGowan(40 por ciento grado I, 40 por ciento grado IIA y 20 por ciento grado IIB). En el 63 por ciento de los casos hubo un síndrome de túnel del carpo asociado que también se trató. En todos los casos se observó una fascia de Osborne tensa y compresiva sobre el nervio ulnar. El seguimiento promedio fue de 3,8 meses y se obtuvo un 100 por ciento de resultados buenos y excelentes. En este trabajo se confirma que ésta es una técnica quirúrgica reproducible y basada en la simplicidad. Se le puede considerar como primera opción para el tratamiento quirúrgico del síndrome de compresión del nervio ulnar en el codo.