Skip to main content
Top
Published in: HAND 2/2011

01-06-2011 | Case Reports

Acute carpal tunnel syndrome secondary to iatrogenic hemorrhage. A case report

Authors: George Kokosis, Gert Blueschke, Matthew Blanton, Howard Levinson, Detlev Erdmann

Published in: HAND | Issue 2/2011

Login to get access

Abstract

Carpal tunnel syndrome is a common compression neuropathy of the median nerve. Acute carpal tunnel syndrome (aCTS) is rare, associated with a variety of conditions. In this case report we present a patient who developed aCTS and volar forearm compartment syndrome after a radial artery line placement, while receiving intravenous heparin. The patient underwent immediate forearm fasciotomy and surgical release for restoration of nerve function, which resulted in improved hand function and mild residual median nerve neuropathy. There is controversy whether to discontinue or not anticoagulation in a patient with aCTS. In our patient, heparin therapy was restarted on the second postoperative day.
Literature
1.
go back to reference Aslam N, Lo S, McNab I. Acute carpal tunnel syndrome caused by a fragment of bone from metatcarpal injury. Injury Extra. 2005;36:73–6.CrossRef Aslam N, Lo S, McNab I. Acute carpal tunnel syndrome caused by a fragment of bone from metatcarpal injury. Injury Extra. 2005;36:73–6.CrossRef
2.
go back to reference Balakrishnan C, Jarrahnejad P, Balakrishnan A, Huettner WC. Acute carpal tunnel syndrome as a result of spontaneous bleeding. Can J Plast Surg. 2008;16:168–9.PubMed Balakrishnan C, Jarrahnejad P, Balakrishnan A, Huettner WC. Acute carpal tunnel syndrome as a result of spontaneous bleeding. Can J Plast Surg. 2008;16:168–9.PubMed
3.
go back to reference Bindiger A, Zelnik J, Kuschner S, Gellman H. Spontaneous acute carpal tunnel syndrome in an anticoagulated patient. Bull Hosp Jt Dis. 1995;54:52–3.PubMed Bindiger A, Zelnik J, Kuschner S, Gellman H. Spontaneous acute carpal tunnel syndrome in an anticoagulated patient. Bull Hosp Jt Dis. 1995;54:52–3.PubMed
4.
go back to reference Black PR, Flowers MJ, Saleh M. Acute carpal tunnel syndrome as a complication of oral anticoagulant therapy. J Hand Surg Br. 1997;22:50–1.PubMed Black PR, Flowers MJ, Saleh M. Acute carpal tunnel syndrome as a complication of oral anticoagulant therapy. J Hand Surg Br. 1997;22:50–1.PubMed
5.
go back to reference Bonatz E, Seabol KE. Acute carpal tunnel syndrome in a patient taking Coumadin: case report. J Trauma. 1993;35:143–4.PubMedCrossRef Bonatz E, Seabol KE. Acute carpal tunnel syndrome in a patient taking Coumadin: case report. J Trauma. 1993;35:143–4.PubMedCrossRef
6.
go back to reference Chiu KY, Ng WF, Wong WB, Choi CH, Chow SP. Acute carpal tunnel syndrome caused by pseudogout. J Hand Surg Am. 1992;17:299–302.PubMedCrossRef Chiu KY, Ng WF, Wong WB, Choi CH, Chow SP. Acute carpal tunnel syndrome caused by pseudogout. J Hand Surg Am. 1992;17:299–302.PubMedCrossRef
7.
go back to reference Faithfull DK, Wallace RF. Traumatic rupture of median artery an unusual cause for acute median nerve compression. J Hand Surg Br. 1987;12:233–5.PubMedCrossRef Faithfull DK, Wallace RF. Traumatic rupture of median artery an unusual cause for acute median nerve compression. J Hand Surg Br. 1987;12:233–5.PubMedCrossRef
8.
go back to reference Hargreaves DG, Gosal H, Moss AL. Another cause for acute carpal tunnel syndrome: tricyclic overdose. J Accid Emerg Med. 1995;12:158–9.PubMed Hargreaves DG, Gosal H, Moss AL. Another cause for acute carpal tunnel syndrome: tricyclic overdose. J Accid Emerg Med. 1995;12:158–9.PubMed
9.
go back to reference Howie CR, Buxton R. Acute carpal tunnel syndrome due to spontaneous haemorrhage. J Hand Surg Br. 1984;9:137–8.PubMedCrossRef Howie CR, Buxton R. Acute carpal tunnel syndrome due to spontaneous haemorrhage. J Hand Surg Br. 1984;9:137–8.PubMedCrossRef
10.
go back to reference Kilpatrick T, Leyden M, Sullivan J, Lawler G, Grossman H. Acute median nerve compression by haemorrhage from acute myelomonocytic leukaemia. Med J Aust. 1985;142:51–2.PubMed Kilpatrick T, Leyden M, Sullivan J, Lawler G, Grossman H. Acute median nerve compression by haemorrhage from acute myelomonocytic leukaemia. Med J Aust. 1985;142:51–2.PubMed
11.
go back to reference Kongsholm J, Olerud C. Carpal tunnel pressure in the acute phase after Colles’ fracture. Arch Orthop Trauma Surg. 1986;105:183–6.PubMedCrossRef Kongsholm J, Olerud C. Carpal tunnel pressure in the acute phase after Colles’ fracture. Arch Orthop Trauma Surg. 1986;105:183–6.PubMedCrossRef
12.
go back to reference Lynch AC, Lipscomb PR. The carpal tunnel syndrome and Colles’ fractures. JAMA. 1963;185:363–6.PubMed Lynch AC, Lipscomb PR. The carpal tunnel syndrome and Colles’ fractures. JAMA. 1963;185:363–6.PubMed
13.
go back to reference Mack GR, McPherson SA, Lutz RB. Acute median neuropathy after wrist trauma. The role of emergent carpal tunnel release. Clin Orthop Relat Res. 1994;300:141–6.PubMed Mack GR, McPherson SA, Lutz RB. Acute median neuropathy after wrist trauma. The role of emergent carpal tunnel release. Clin Orthop Relat Res. 1994;300:141–6.PubMed
14.
go back to reference Manske PR. Fracture of the hook of the hamate presenting as carpal tunnel syndrome. Hand. 1978;10:181–3.PubMedCrossRef Manske PR. Fracture of the hook of the hamate presenting as carpal tunnel syndrome. Hand. 1978;10:181–3.PubMedCrossRef
15.
go back to reference Martin SD, Sharrock NE, Mineo R, Sobel M, Weiland AJ. Acute exacerbation of carpal tunnel syndrome after radial artery cannulation. J Hand Surg Am. 1993;18:455–8.PubMedCrossRef Martin SD, Sharrock NE, Mineo R, Sobel M, Weiland AJ. Acute exacerbation of carpal tunnel syndrome after radial artery cannulation. J Hand Surg Am. 1993;18:455–8.PubMedCrossRef
16.
go back to reference McClain EJ, Wissinger HA. The acute carpal tunnel syndrome: nine case reports. J Trauma. 1976;16:75–8.PubMedCrossRef McClain EJ, Wissinger HA. The acute carpal tunnel syndrome: nine case reports. J Trauma. 1976;16:75–8.PubMedCrossRef
17.
go back to reference McDonald 3rd AP, Lourie GM. Complex surgical conditions of the hand: avoiding the pitfalls. Clin Orthop Relat Res. 2005;433:65–71.PubMedCrossRef McDonald 3rd AP, Lourie GM. Complex surgical conditions of the hand: avoiding the pitfalls. Clin Orthop Relat Res. 2005;433:65–71.PubMedCrossRef
18.
19.
go back to reference Molitor PJ, Wimperis JZ. Acute carpal tunnel syndrome in haemophiliacs. Br J Clin Pract. 1990;44:675–6.PubMed Molitor PJ, Wimperis JZ. Acute carpal tunnel syndrome in haemophiliacs. Br J Clin Pract. 1990;44:675–6.PubMed
20.
go back to reference Nkele C. Acute carpal tunnel syndrome resulting from haemorrhage into the carpal tunnel in a patient on warfarin. J Hand Surg Br. 1986;11:455–6.PubMedCrossRef Nkele C. Acute carpal tunnel syndrome resulting from haemorrhage into the carpal tunnel in a patient on warfarin. J Hand Surg Br. 1986;11:455–6.PubMedCrossRef
21.
22.
go back to reference Olerud C, Lonnquist L. Acute carpal tunnel syndrome caused by fracture of the scaphoid and the 5th metacarpal bones. Injury. 1984;16:198–9.PubMedCrossRef Olerud C, Lonnquist L. Acute carpal tunnel syndrome caused by fracture of the scaphoid and the 5th metacarpal bones. Injury. 1984;16:198–9.PubMedCrossRef
23.
go back to reference Ortiz Jr JA, Berger RA. Compartment syndrome of the hand and wrist. Hand Clin. 1998;14:405–18.PubMed Ortiz Jr JA, Berger RA. Compartment syndrome of the hand and wrist. Hand Clin. 1998;14:405–18.PubMed
24.
go back to reference Paget J. The first description of carpal tunnel syndrome. J Hand Surg Eur. 2007;32:195–7.CrossRef Paget J. The first description of carpal tunnel syndrome. J Hand Surg Eur. 2007;32:195–7.CrossRef
25.
go back to reference Paley D, McMurtry RY. Median nerve compression by volarly displaced fragments of the distal radius. Clin Orthop Relat Res. 1987;215:139–47.PubMed Paley D, McMurtry RY. Median nerve compression by volarly displaced fragments of the distal radius. Clin Orthop Relat Res. 1987;215:139–47.PubMed
26.
go back to reference Parthenis DG, Karagkevrekis CB, Waldram MA. von Willebrand’s disease presenting as acute carpal tunnel syndrome. J Hand Surg Br. 1998;23:114.PubMedCrossRef Parthenis DG, Karagkevrekis CB, Waldram MA. von Willebrand’s disease presenting as acute carpal tunnel syndrome. J Hand Surg Br. 1998;23:114.PubMedCrossRef
27.
go back to reference Phalen GS. The carpal-tunnel syndrome. Seventeen years’ experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am. 1966;48:211–28.PubMed Phalen GS. The carpal-tunnel syndrome. Seventeen years’ experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am. 1966;48:211–28.PubMed
28.
go back to reference Qvist J, Peterfreund RA, Perlmutter GS. Transient compartment syndrome of the forearm after attempted radial artery cannulation. Anesth Analg. 1996;83:183–5.PubMed Qvist J, Peterfreund RA, Perlmutter GS. Transient compartment syndrome of the forearm after attempted radial artery cannulation. Anesth Analg. 1996;83:183–5.PubMed
29.
go back to reference Sanchez-Garcia ML, Riesgo MJ, Benito-Alcala MC, et al. Late ischemia and carpal tunnel syndrome secondary to catheterization of the radial artery. Rev Esp Anestesiol Reanim. 1997;44:201–3.PubMed Sanchez-Garcia ML, Riesgo MJ, Benito-Alcala MC, et al. Late ischemia and carpal tunnel syndrome secondary to catheterization of the radial artery. Rev Esp Anestesiol Reanim. 1997;44:201–3.PubMed
30.
go back to reference Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care. 2002;6:199–204.PubMedCrossRef Scheer B, Perel A, Pfeiffer UJ. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. Crit Care. 2002;6:199–204.PubMedCrossRef
31.
go back to reference Schnetzler KA. Acute carpal tunnel syndrome. J Am Acad Orthop Surg. 2008;16:276–82.PubMed Schnetzler KA. Acute carpal tunnel syndrome. J Am Acad Orthop Surg. 2008;16:276–82.PubMed
32.
go back to reference Sparkes JM, Kingston R, Keogh P, O’Flanagan SJ. Acute forearm compartment syndrome: report of three cases and a review of the literature. Ir J Med Sci. 2000;169:141–2.PubMedCrossRef Sparkes JM, Kingston R, Keogh P, O’Flanagan SJ. Acute forearm compartment syndrome: report of three cases and a review of the literature. Ir J Med Sci. 2000;169:141–2.PubMedCrossRef
33.
go back to reference Sterling AP, Eshraghi A, Anderson WJ, Habermann ET. Acute carpal tunnel syndrome secondary to a foreign body within the median nerve. Bull Hosp Joint Dis. 1972;33:130–4.PubMed Sterling AP, Eshraghi A, Anderson WJ, Habermann ET. Acute carpal tunnel syndrome secondary to a foreign body within the median nerve. Bull Hosp Joint Dis. 1972;33:130–4.PubMed
34.
go back to reference Szabo RM. Acute carpal tunnel syndrome. Hand Clin. 1998;14:419–9.PubMed Szabo RM. Acute carpal tunnel syndrome. Hand Clin. 1998;14:419–9.PubMed
35.
go back to reference Ward CM, Lueck NE, Steyers CM. Acute carpal tunnel syndrome caused by diffuse giant cell tumor of tendon sheath: a case report. Iowa Orthop J. 2007;27:99–103.PubMed Ward CM, Lueck NE, Steyers CM. Acute carpal tunnel syndrome caused by diffuse giant cell tumor of tendon sheath: a case report. Iowa Orthop J. 2007;27:99–103.PubMed
36.
go back to reference Weiland AJ, Lister GD, Villarreal-Rios A. Volar fracture dislocations of the second and third carpometacarpal joints associated with acute carpal tunnel syndrome. J Trauma. 1976;16:672–5.PubMedCrossRef Weiland AJ, Lister GD, Villarreal-Rios A. Volar fracture dislocations of the second and third carpometacarpal joints associated with acute carpal tunnel syndrome. J Trauma. 1976;16:672–5.PubMedCrossRef
Metadata
Title
Acute carpal tunnel syndrome secondary to iatrogenic hemorrhage. A case report
Authors
George Kokosis
Gert Blueschke
Matthew Blanton
Howard Levinson
Detlev Erdmann
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
HAND / Issue 2/2011
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-010-9298-0

Other articles of this Issue 2/2011

HAND 2/2011 Go to the issue