Neurovascular-derived masses on the digital bundle topographically at the finger

Abstract

The arteries supplying the fingers and sensory nerve are located on the radial and ulnar aspects of the fingers, which are called the digital bundle. Masses can be found on this bundle topographically. This study aimed to investigate whether this mass originates from the neurovascular structure in patients presenting with a mass on the digital bundle topographically between the A1 pulley-distal interphalangeal (DIP)/interphalangeal (IP) joint in the finger. Additionally, it aimed to determine whether tumors originating from neurovascular structures originate from the main digital bundle and the steps involved in their reconstruction. We reviewed 27 cases with mass lesions at the digital bundle trace topographically between the A1 pulley and DIP/IP, which underwent surgery and were confirmed by histopathological examination between October 2014 and April 2022. Each patient requested at least two plane radiographs, US and MRI. All patients underwent surgery under a loupe-magnification or microscope. First, we determined whether the mass lesion originated from a main digital artery or nerve. Thereafter, the relationship of the mass with pulley and tendon structures was evaluated. All patients underwent histopathological examination. Mean follow-up 21 months. The mean age was 39.3 years. The pain was the most common presenting complaint and was observed in 13 patients. The tumors originating from neurovascular structures were found in 10 patients. In 5 patients, the tumor originated from the main digital artery and nerve. Three of them were reconstructed with a nerve graft. The most common non-neurovascular tumors were giant cell tendon sheath tumors and epidermal inclusion cysts. Some of the tumors on the topographically digital bundle are of neurovascular in origin. Reconstruction can be made in tumors originating from the main digital bundle. Again, the protection of pulley and tendon structures in this region is important in terms of morbidity.