Incidental finding of a persistent median artery (palmar type) during a routine carpal tunnel decompression: a case report

Author:

Butt J1,Ahluwalia AK1,Dutta A1

Affiliation:

1. Lewisham and Greenwich NHS Foundation Trust, Queen Elizabeth Hospital, Trauma and Orthopaedics, London, UK

Abstract

Carpal tunnel syndrome is characterised by compression of the median nerve. The mainstay of treatment is surgical decompression. This case report highlights the occurrence of a persistent median artery, which could complicate surgery. A 55-year-old woman underwent carpal tunnel decompression. An incidental finding of a large-calibre persistent median artery, which was superficial to the flexor sheath, could have been damaged. This was carefully retracted and the procedure was completed, without any complications. Several studies have shown the prevalence of persistent median artery to range from 1.1–27.1%. It is usually found deep to the flexor retinaculum but in this case it was found to be just beneath the palmar fascia. There is increased chance of iatrogenic injury with this particular variant. Surgeons performing the procedure should be mindful of this variation, because accidental damage could result in devastating consequences to the hand.

Publisher

Royal College of Surgeons of England

Subject

General Medicine,Surgery

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