RESUMO
Most cases of carpal tunnel syndrome are idiopathic. One condition associated with carpal tunnel syndrome is a lipofibromatous hamartoma. We describe a case of a lipofibromatous hamartoma presenting as a soft tissue wrist swelling with associated symptoms and signs of carpal tunnel syndrome. We advocate that all soft tissue swellings of the wrist with associated neurological signs be investigated appropriately, avoiding unnecessary additional surgery.
Assuntos
Tecido Adiposo/patologia , Síndrome do Túnel Carpal/etiologia , Hamartoma/complicações , Neuropatia Mediana/complicações , Procedimentos de Cirurgia Plástica/métodos , Adulto , Biópsia , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Hamartoma/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Neuropatia Mediana/diagnóstico , Neuropatia Mediana/cirurgiaRESUMO
Reconstruction of the lower extremity using microvascular free tissue transfer has been adopted as a routine procedure since the 1980s. Success rates in overall free tissue transfer are now as high as 98%. In the lower limb, however, the failure rate has been reported to be as high as 15 to 20%. A review of 50 consecutive microvascular free flaps to the lower extremity was carried out in the Ulster Hospital Belfast. The indication for surgery, the flap type, the recipient vessel, re-exploration rate, complication rate, success rate and the changing pattern in management during the first six years of a single consultant's practice was assessed. Six patients (12%) were re-explored for anastomotic complications or haematoma. Thrombosis of the arterial anastomosis was noted in one case, venous thrombosis in two and haematoma under the flap in the remaining three cases. Salvage was successful in four cases, thus producing an overall success rate of 96%.
