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Compression Neuropathy of the Ulnar Digital Nerves in the Thumbs of a Massage Therapist

Chen, Chien-Chang MD; Chien, Hsiung-Fei MD, PhD; Chen, Chien-Lian MD

doi: 10.1097/SAP.0b013e31826a1607
Hand Surgery

Abstract: Compression neuropathies of digital nerves, caused by hypertrophied or anomalous muscles, are rare compared with such occurrences above the wrist. We reported a case of compression neuropathy of the ulnar digital nerves in bilateral thumbs of a massage therapist. Entrapment of the digital nerves by the hypertrophied first dorsal interosseous and adductor pollicis muscles over the first web space of the right hand was detected by magnetic resonance imaging. Surgical debulking of the muscles and neurolysis were performed on the dominant right hand. The left hand was successfully treated with botulinum toxin. No recurrence was noted in a follow-up of 36 months.

From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan.

Received April 8, 2012, and accepted for publication, after revision, July 16, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Chien-Lian Chen, MD, Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan, No.25, Lane 442, Sec. 1, Jingguo Rd., Hsinchu City 30059, Taiwan. E-mail: superchiehliang@yahoo.com.tw.

© 2014 by Lippincott Williams & Wilkins