Role of ultrasonography for evaluation of nerve recovery in repaired median nerve lacerations.

This study aimed to investigate whether ultrasonographic inspection of the repair site of median nerve lacerations may provide useful evidence about the functional outcome in the affected hand. Forty-three patients with complete transection of the median nerve at the distal forearm were examined at a median of 40.9 months after operation by detailed ultrasonographic imaging and clinical assessment of the affected hand by the Michigan Hand Questionnaire and Rosén-Lundborg Protocol to investigate the quality of nerve healing. The continuity of individual nerve fascicles was assessed and the cross-sectional area of the enlarged nerve at the repair site was measured and compared with the contralateral median nerve at the same level. An enlargement ratio for the repair site of each nerve was calculated and compared with the numeric results obtained from the two clinical tests. A statistically significant reverse correlation was observed between nerve enlargement and the functional results of the repaired nerve.Level of evidence: IV.

Correlations between ultrasonography findings and surgical findings in patients with refractory symptoms after primary surgical release for carpal tunnel syndrome.

OBJECTIVE: Surgical carpal tunnel release is very effective for symptom relief in carpal tunnel syndrome, and it remains the preferred choice of treatment. However, refractory symptoms following surgical release are not uncommon. We aimed to assess the usefulness of ultrasonography for determining the potential causes of ongoing symptoms following surgical release. METHODS: This retrospective study included 34 patients (32 women; mean age, 54.7±16.65 years; range: 30 to 81 years) with carpal tunnel syndrome who underwent surgical carpal tunnel release. RESULTS: A pathology related to the cause of the ongoing symptoms was detected by ultrasonography in 25 (74.5%) patients. The most common pathological findings were median nerve swelling (70.6%), incomplete transection of the transverse carpal ligament (23.5%) and perineural fibrosis (17.6%). CONCLUSION: In the majority of the patients the pathology related to the ongoing symptoms was detected by ultrasonography, suggesting that ultrasonography could be used as a complementary imaging method for identifying the causes of failure following surgical carpal tunnel release. Detection of an ongoing pathology might help clinicians in managing persistent disease cases and aid in planning an exploration.

[Case report: Tenosynovial giant cell tumor arising from the knee joint]. / Diz ekleminde yerlesim gösteren tenosinovyal dev hücreli tümör.

Giant cell tumor of the tendon sheath and synovium or pigmented villonodular synovitis of the tendon is a benign neoplasm, although there are rarely reported malignant metastatic forms. The most common location is the hand. Large joints such as the ankle and knee are infrequently affected. Diagnosis might be suspected radiologically, but the exact diagnosis has to be confirmed by histopathologic examination. In this study, we report MRI findings of three giant cell tumors of the tendon sheath.