[Carpal tunnel compression syndrome and third finger in trigger secondary to an encapsulated fibrolipoma of the wrist: a case report].

Abstract

Introduction: the association of carpal tunnel syndrome with stenosing tenosynovitis of the hand is very rare, even more, if it is generated by a fibrolipoma at the carpal tunnel. The imaging study useful to detect this type of hand injuries are X-ray screening for carpal tunnel, computed tomography and magnetic resonance imaging. But these are not commonly used for the study of protocolized carpal tunnel syndrome and much less trigger finger.

Objective: the aim of this work is to report a case of a middle-aged female with carpal tunnel syndrome characteristic symptoms, associated with the third trigger finger; she was handled with the release of the median nerve by a minimally invasive approach, in addition to the A1 pulley release.

Clinical case: the patient persists with both problems and at a secondary surgical review, we detected wrist locking sensation. The patient was reoperated finding an ovoid encapsulated tumor, measuring 3.0 × 2.0 × 1.0 cm, with smooth outer surface, whitish appearance, and soft rubbery consistency. The biopsy pathology outlines identified an encapsulated fibrolipoma, causing nerve compression and locking flexor tendon.

Conclusion: the importance of this writing is in adding tumors to the etiological repertoire, which can cause compression of the median nerve and even less frequent as a cause of the flexor tendons of the hand snagging.