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Severe Carpal Tunnel Syndrome with Ulcerative Complications: A Case Report

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Resumo:Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder, affecting 1% to 5% of adults, primarily women aged 40-60. It results from median nerve compression, causing pain, numbness, and reduced grip strength. Risk factors include rheumatoid arthritis, pregnancy, and hypertension. Advanced cases may present with painless skin ulcers, suggesting an ulceromutilating variant. An 83-year-old retired seamstress with hypertension, rheumatoid arthritis, and bilateral CTS, diagnosed nine years ago, developed progressive sensory-motor deficits and painless ulcers on her left hand despite successful right-hand surgery. Electromyography confirmed severe left CTS and the clinical presentation suggested an ulceromutilating variant. She was referred for corrective surgery. Painless ulcers in CTS are rare but have been reported since 1979, resulting from prolonged nerve compression and skin necrosis. Early diagnosis and surgery are crucial to prevent irreversible damage, like bone resorption. This case emphasizes the need to consider this variant in advanced CTS.
Autores principais:Campos Correia, Sofia
Outros Autores:Heitor, Joana
Assunto:Neuropatia Mediana Síndrome do Túnel Cárpico Úlcera Carpal Tunnel Syndrome Median Neuropathy Ulcer
Ano:2026
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:CUF
Idioma:inglês
Origem:Gazeta Médica
Descrição
Resumo:Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder, affecting 1% to 5% of adults, primarily women aged 40-60. It results from median nerve compression, causing pain, numbness, and reduced grip strength. Risk factors include rheumatoid arthritis, pregnancy, and hypertension. Advanced cases may present with painless skin ulcers, suggesting an ulceromutilating variant. An 83-year-old retired seamstress with hypertension, rheumatoid arthritis, and bilateral CTS, diagnosed nine years ago, developed progressive sensory-motor deficits and painless ulcers on her left hand despite successful right-hand surgery. Electromyography confirmed severe left CTS and the clinical presentation suggested an ulceromutilating variant. She was referred for corrective surgery. Painless ulcers in CTS are rare but have been reported since 1979, resulting from prolonged nerve compression and skin necrosis. Early diagnosis and surgery are crucial to prevent irreversible damage, like bone resorption. This case emphasizes the need to consider this variant in advanced CTS.