Abstract
BackgroundCarpal tunnel syndrome is a common condition in adults with an estimated prevalence of up to 5% in the general population. The presence of a persistent median artery is an important consideration for plastic and orthopedic surgeons who frequently perform carpal tunnel release. This artery may persist into adulthood and constitute a significant supply of blood to the hand, sometimes compressing the median nerve. PurposeIn this case series, we describe the prevalence of the persistent median artery identified intraoperatively in Polish subjects undergoing surgical open carpal tunnel release. MethodsThe data regarding the prevalence of persistent median artery were retroactively collected postoperatively from the standard surgical protocols. ResultsPersistent median artery was identified in 36 out of 1285 operated hands (2.8%). The observed PMAs were identified in 15 (2.0%) cases out of 750 right upper limbs and in 21 (3.9%) cases out of the 535 left upper limbs. ConclusionsPersistent median artery can be present in the operating field of any surgeon that performs carpal tunnel release and any other surgical procedures in the wrist region. Therefore awareness of its presence is crucial to minimize intraoperative complications such as bleeding or digital ischemia.
Highlights
The median artery is an embryological structure that represents the main blood supply to the hand during the first trimester of embryonic development [1]
Carpal tunnel syndrome is a common condition in adults with an estimated prevalence of up to 5% in the general population with women understood to be affected more than men [3]
We describe the prevalence of the persistent median artery identified intraoperatively in Polish subjects undergoing surgical decompression for carpal tunnel syndrome
Summary
The median artery is an embryological structure that represents the main blood supply to the hand during the first trimester of embryonic development [1]. According to Natsis et al (2009), if present, the persistent median artery (PMA) is the main supply of blood to the median nerve. This ar tery may persist into adulthood and cause symptoms consistent with median nerve disturbances; either by compression when accompanying the median nerve through the carpal tunnel or iatrogenic ischemia. The presence of a persistent median artery is an important consideration for plastic and orthopedic surgeons who frequently perform carpal tunnel release. This artery may persist into adulthood and constitute a significant supply of blood to the hand, sometimes compressing the median nerve. Awareness of its presence is crucial to minimize intraoperative complications such as bleeding or digital ischemia
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