[ effect of presence of palmaris longus and fifth superficial flexor tendons on median nerve surface area; a cross-sectional study with sonography]

Background and Aims: Sonography has enjoyed much attention as a noninvasive diagnostic tool for carpal tunnel syndrome in recent years. The aim of the present study was to assess the effect of anatomic variations of existence or absence of palmaris longus and fifth superficial flexor tendons on the sonographic measurement of median nerve surface area in healthy individuals' wrists

Methods: 93 volunteers without any symptoms related to carpal tunnel syndrome underwent clinical evaluation for determining presence of tendons in both wrists and also, sonographic measurement of median nerve surface area

Results: In 22 of 186 hands [11.82%], there was absence of the palmaris longus tendon and absence of the fifth flexor was noted in 8 [4.30%]. The median nerve surface area in the hands without palmaris longus was meaningfully less than the hands with it [P = 0.025], while the difference in the median nerve surface area was not statistically significant regarding the presence of the fifth flexor [P = 0.324]

Conclusion: Based on the findings of the present study, it seems that the median nerve surface, area as a sonographic finding, is probably related to presence or absence of the palmaris Longus tendon. So, those hands with the tendon present have larger surface areas. Also, it seems that this sonographic finding is not dependent on the presence of fifth superficial flexor tendon

Infected textiloma, 35 years after the operation for femur fracture, an extermly rare occurance

Retained gauze after surgery is an uncommon error and it may be associated with many complications. We are reporting our case to call attention to the fact that retained gauze may become symptomatic even after a very long interval. Herein we report on a patient who developed infection and fistula with discharge from this error 35 years after a surgery for femur fracture and insertion of a IM nail. The diagnosis was easily made because of a marker in the gauze. Removal of the gauze and irrigation and debridement of the wound in two stages led to complete recovery of the patient as was shown in the 1 year follow up. Retained gauze after surgery is a preventable complication and may be asymptomatic for a very long period, but can become a complication post-operatively at any time. Hence, if diagnosed immediately after the surgery or at any other time, the gauze should be removed