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Öğe Aperture fixation instead of transverse tunnels at the patella for medial patellofemoral ligament reconstruction(Springer, 2012) Hapa, Onur; Aksahin, Ertugrul; Ozden, Raif; Pepe, Murad; Yanat, Ahmet Nedim; Dogramaci, Yunus; Bozdag, ErgunMedial patellofemoral ligament (MPFL) reconstruction is an effective option for the treatment of recurrent patellar instability. Most techniques utilize the passage of a tendon graft through tunnels at the patella with the risk of patellar fracture. The purpose of this study was to investigate the strength of the recent MPFL reconstruction techniques (transverse tunnel, interference screw, anchor, and docking technique). Thirty-six saw bones were divided into four groups (transverse tunnel, interference screw, anchor fixation, and docking technique) with nine patellae in each. Patella-tendon constructs were pre-loaded to 10 N and cyclically loaded for 20 cycles from 2 to 30 N under load control at a rate of 5 N/sec. The construct was then tested to failure at a constant displacement rate of 6 mm/sec. Ultimate load (N), stiffness (N/mm), and failure mode were recorded for each specimen. The docking group had lower ultimate load [106 (SD 41) N] and stiffness [14 (SD 2) N/mm] values than the other groups tested (P = 0.007). The anchor group had lower stiffness [21 (SD 6) N/mm] values than the tunnel group [28 (SD 3) N/mm (P = 0.01)] and the interference screw group [31 (SD 6) N/mm, (P = 0.004)]. There was no significant difference in the ultimate load between anchor [299 (SD 116) N], tunnel [304 (SD 140) N], and interference screw groups [241 (SD 103) N] (n.s.). Aperture fixation techniques, especially interference screw fixation, were as strong as the technique utilizing tunnels in the patella for MPFL reconstruction.Öğe Ayak parmağında tendon kılıfı dev hücreli tümörü : Üç olgu sunumu(2008) Kalaycı, Aydıner; Özkan, Cenk; Sevinç, Teoman Toni; Yanat, Ahmet NedimTendon kılıfı sinovyal hücrelerinden köken alan iyi huylu yumuşak doku tümörüdür. Ayak parmaklarında görülmesi nadirdir. Bu yazıda ayak parmakları tendon kılıfından köken alan dev hücreli tümör nedeniyle tedavi edilen üç olgu sunuldu. Olguların ikisi kadın (yaş 25 ve 50), biri erkekti (yaş 21). Üç hastada da ayak parmaklarında hafif ağrılı yumuşak doku kitlesi vardı. Manyetik rezonans görüntüleme ayırıcı tanıda yardımcı olmadı. Tanı tümüyle çıkarılan kitlelerin histopatolojik değerlendirilmesiyle kondu. Ortalama 18 aylık takipte hiçbir olguda lokal nüks görülmedi.Öğe Bilateral carpal and tarsal tunnel syndrome in the same patient : A case report(2008) Serarslan, Yurdal; Kalacı, Aydıner; Akdemir, Gökhan; Yanat, Ahmet NedimKlinik muayene ve elektrofizyolojik çalışmalarla tanı konmuş, iki taraflı ciddi tarsal tünel sendromlu ve iki taraflı ciddi karpal tünel sendromlu, nadir bir vaka sunuyoruz. Kompresyon nöropatisi, özellikle iki taraflı veya multipl olduğunda sistemik bir hastalığa sekonder olabilir. Literatürde, bugüne kadar, aynı hastada iki taraflı tarsal tünel sendromu ve iki taraflı karpal tünel sendromu, sadece bir kaç vakada bildirilmiştir.Öğe Bilateral carpal and tarsal tunnel syndrome in the same patient: A case report(Journal Neurological Sciences, 2008) Serarslan, Yurdal; Kalacı, Aydıner; Akdemir, Goekhan; Yanat, Ahmet NedimWe report, an unique case with co-existing bilateral severe tarsal tunnel syndrome (TTS) and bilateral severe carpal tunnel syndrome (CTS), which were diagnosed by clinical examination and electrophysiological studies. Compression neuropathy, especially when bilateral or multiple may be secondary to a systemic disease. To date, bilateral carpal and tarsal tunnel syndromes in the same patient have been reported only a few cases in the literature.Öğe Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report(Thieme Medical Publ Inc, 2008) Sevinc, Teoman Toni; Kalacı, Aydıner; Dogramaci, Yunus; Yanat, Ahmet NedimWe report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.Öğe A comparison of fucidic acid and cefazoline released from cancellous human bone(Academic Journals, 2011) Dogramaci, Yunus; Kalacı, Aydıner; Ozer, Burcin; Ozden, Raif; Hapa, Onur; Yanat, Ahmet NedimThis study was designed to determine the antibacterial activity of fucidic acid or cefazoline in cancellous bone obtained from patients undergoing total knee replacement. Thirty samples of cancellous bone were obtained from patients undergoing total joint arthroplasty for primary osteoarthritis of knee joints. The prophylactic antibiotics were infused to the subjects an hour before the operation. In the first group (15 samples) fucidic acid (500 mg intravenous) was used as a prophylactic antibiotics and 1st generation of cephalosporin were used in the second group (15 samples) as the prophylaxis. Same strains of Staphyloccocus aureus were used to assess the antibiotic activity using the disc diffusion technique after 1, 3, 7, 10, 14, 18, 21 and 28 days. The antibiotic efficacy was defined as an inhibition zone diameter of 10 mm. Inhibition zone diameters were significantly higher in fusidic acid than cefazoline specimens on the first, third and 14th day after the incubation (P<0.05). No statistically significant difference was found in the inhibition zone diameter at the seventh, 18th and 21st days. Evaluation of inhibition zone diameters showed that samples obtained from the first group (fucidic acid) had a longer duration of antibiotic release than that of second group (cefazolin). Fucidic acid shows a higher release and a longer antibacterial activity when used as a prophylactic antibiotic compared to cefazolin.Öğe Cutaneous infection caused by Aspergillus terreus(Soc General Microbiology, 2009) Ozer, Burcin; Kalacı, Aydıner; Duran, Nizami; Dogramaci, Yunus; Yanat, Ahmet NedimAspergillus species are widely distributed in nature, and more than 30 species have been reported to be involved in human and animal infection. Cutaneous infections due to Aspergillus terreus are particularly rare. In this report, we describe a case of cutaneous infection caused by A. terreus in a paediatric patient who underwent surgical treatment for an open tibial fracture secondary to an agricultural accident.Öğe Detection of parvovirus B19 in synovial fluids of patients with osteoarthritis(Elsevier Science Inc, 2008) Aslan, Bahadir; Serin, Mehmet Sami; Aslan, Gonul; Kalacia, Aydiner; Yanat, Ahmet Nedim; Tezcan, Seda; Emekdas, GurolWe aimed to determine the possible role of parvovirus B19 (PVB19) in the etiology of osteoarthritis. PVB19 DNA, anti-VP1 IgM and IgG, and interleukin IL-6 levels were also assayed in synovial fluids of 42 patients with osteoarthritis and 10 controls. PVB19 DNA was detected in 28 of 42 (66.66%) in patients and in 3 of 10 (30%) in controls. IgG and IgM response were detected in 21 of 42 (50.00%) and in 2 of 42 (4.76%) patients, respectively. IL-6 were positive in 15 of 42 (36%) patients and in 3 of 10 (30%) controls. All IgG (+) samples had PVB19 DNA (100%, P < 0.001). Eleven of 15 IL-6 (+) samples had PVB19 DNA (+) (73.33%, P < 0.05). Moreover, all IL-6 (+) samples (n = 5) in stage IV had PVB19 DNA (+) (100%, P < 0.001). We have detected a significant association between the stages of osteoarthritis and PVB 19 DNA (P < 0.05). These findings support the presence of PVB 19 acting as a transactivator of IL-6 expression as reported earlier. Our results also suggest that the higher stages of osteoarthritis might be related to the increased inflammation and cell damage on joint cartilage due to PVB19. (C) 2008 Elsevier Inc. All rights reserved.Öğe Diz osteoartritli hastalarda eklem sıvısında nitrik oksit değerleri ve süperoksit dismutaz enzim aktiviteleri(2007) Kalacı, Aydıner; Uz, Efkan; Aslan, Bahadır; Söğüt, Sadık; Özkan, Cenk; Yanat, Ahmet NedimAmaç: Diz osteoartritli (OA) hastaların eklem sıvısında nitrik oksit (NO) düzeyi ve süperoksit dismutaz (SOD) enzim aktivitesi araştırıldı. Hastalar ve yöntemler: Amerikan Romatoloji Birliği OA ölçütlerine uyan 36 hasta (31 kadın, 5 erkek; ort. yaş 63; dağılım 48-88) çalışmaya alındı. Hastaların diz grafileri Kellgren-Lawrence radyografik sınıflamasına göre derecelendirildi. Sinovyal sıvı örnekleri, OA nedeniyle diz protezi veya hiyaluronik asit enjeksiyonu yapılan hastalardan girişimden önce iğne aspirasyonuyla toplandı, daha sonra Eppendorf tüplerine aktarılarak -80 °C’de saklandı. Sinovyal sıvıdaki nitrit ve nitrat değerleri Griess reaksiyonuna dayalı spektrofotometrik yöntemle belirlendi. Toplam SOD aktivitesi de spektrofotometrik yöntemle ölçüldü. Sonuçlar, diz eklemleri klinik ve radyografik olarak normal bulunan, ancak nedeni bilinmeyen diz ağrısından dolayı artroskopi uygulanan 10 hastayla (6 kadın, 4 erkek; ort. yaş 49; dağılım 26-70) karşılaştırıldı. Bulgular: Osteoartritli hasta grubunda NO düzeyi kontrol grubuna göre anlamlı derecede yüksek, SOD aktivitesi düşük bulundu (p<0.001). Kellgren-Lawrence radyografik derecelendirme grupları arasında NO ve SOD değerleri açısından anlamlı fark yoktu (p>0.05). Sonuç: Bulgularımız NO’nun kıkırdak yıkım mediyatörü, SOD’nin ise antioksidan mediyatör olduğunu düşündürmektedir. Bu değerlerin klinik önemini aydınlatmak için daha kapsamlı çalışmalara ihtiyaç vardır.Öğe Does strand configuration and number of purchase points affect the biomechanical behavior of a tendon repair? A biomechanical evaluation using different Kessler methods of flexor tendon repair(2008) Dogramaci, Yunus; Kalacı, Aydıner; Sevinç, Teoman Toni; Esen, Erdinc; Komurcu, Mahmut; Yanat, Ahmet NedimThis study compares the mechanical properties of modified Kessler and double-modified Kessler flexor tendon repair techniques and evaluates simple modifications on both methods. Forty fresh sheep flexor tendons were divided equally into four groups. A transverse sharp cut was done in the middle of each tendon and then repaired with modified Kessler technique, modified Kessler with additional purchase point in the midpoint of each longitudinal strand, double-modified Kessler technique, or a combination of outer Kessler and inner cruciate configuration based on double-modified Kessler technique. The tendons were tested in a tensile testing machine to assess the mechanical performance of the repairs. Outcome measures included gap formation and ultimate forces. The gap strengths of the double-modified Kessler technique (30.85 N, SD 1.90) and double-modified Kessler technique with inner cruciate configuration (33.60 N, SD 4.64) were statistically significantly greater than that of the two-strand modified Kessler (22.56 N, SD 3.44) and modified Kessler with additional purchase configuration (21.75 N, SD 4.03; Tukey honestly significant difference test, P < 0.000). There were statistically significant differences in failure strengths of the all groups (analysis of variance, P < 0.000). With an identical number of strands, the gap formation and ultimate forces of the repairs were not changed by additional locking purchase point in modified Kessler repair or changing the inner strand configuration in double-modified Kessler repair. The results of this study show that the number of strands across the repair site together with the number of locking loops clearly affects the strength of the repair; meanwhile, the longitudinal strand orientation and number of purchase points in a single loop did not affect its strength. © American Association for Hand Surgery 2008.Öğe Effects of hyaluronan on nitric oxide levels and superoxide dismutase activities in synovial fluid in knee osteoarthritis(Springer London Ltd, 2007) Kalacı, Aydıner; Yilmaz, H. Ramazan; Aslan, Bahadir; Soeguet, Sadik; Yanat, Ahmet Nedim; Uz, EfkanThe aim of the present study was to evaluate the effects of hyaluronan (HA) on nitric oxide (NO) levels and superoxide dismutase (SOD) enzyme activities in synovial fluid (SF) in the treatment of patients with knee osteoarthritis (OA). SF samples were aspirated from OA patients before the commencement of the treatment (n=23) and 6 weeks after they were treated with HA products. NO levels and SOD activities were compared between the pre- and post-treatment of OA patients and of the control group (n=10). SF NO levels were significantly higher in patients with OA before the commencement of the treatment compared with the post-treatment (p < 0.001) and the control groups. The SF SOD activity of patients before the commencement of the treatment was lower than the values in the controls and post-treatment (p < 0.001). There is no significant correlation between SF NO and SOD levels and the radiographic changes of the OA knee according to Kellgren-Lawrence grading (p > 0.05). Also, the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) pain scores and physical function scores were gradually improved. These findings made us think that SF NO was a potent mediator in cartilage damage in OA, whereas SOD was an antioxidant mediator in the same process. Exogenous HA injections might reduce the NO levels and increase SOD activities in synovial fluid. These effects also do not seem to be dependent on the radiographic grading of the OA knee. More comprehensive studies are needed to clarify a possible clinical significance of this topic, and we suggest that this is an important area for further research into new treatment options.Öğe Effects of vitamin D3 and calcium on fracture healing in rats(Turkiye Klinikleri, 2006) Aslan, Bahadir; Kalaci, Aydmer; Bozlar, Murat; Atik, Esin; Yanat, Ahmet Nedim; Taşçi, ArzuObjective: We aimed in this study, to evaluate the effects and mechanism of action of single high-dose vitamin D3 and calcium on fracture healing in rats. Material and Methods: A total of 40 rats were divided into four groups; the first group (Group A) was treated with calcium, the second group (Group B) with vitamin D3, the third group (Group C) with calcium and vitamin D3 combination, and the fourth group was the control group (Group D). Tibiae of the rats were osteotomized by a Gigli saw. All rats were sacrificed 3 weeks after surgery. The results obtained were compared by mechanical testing, histological examination and radiographic evaluation. Results: Mean radiographic scores were 1.6 ± 0.8 for group D; 1.7 ± 0.8 for group A; 2.3 ± 0.8 for group B; and 2.4 ± 0.7 for group C. There was a statistically significant difference between the mean radiographic scores of only groups C and D (p = 0.037). There was also a statistically significant difference between the corresponding fracture load values of group D and all the other groups (p = 0.000), but there was no such difference between the corresponding fracture load values of the groups A and B (p = 0.208). Mean histological scores were 5.6 ± 2.7 for group D; 6.0 ± 2.7 for group A; 7.0 ± 2.1 for group B; and 7.2 ± 1.9 for group C (p> 0.05). Conclusion: These results suggested that the real effect of vitamin D on fracture healing was via calcium metabolism. We conclude that calcium and vitamin D given in the early stages of fracture healing gave opportunity for early weight bearing. Copyright © 2006 by Türkiye Klinikleri.Öğe Erişkin kubitus varus deformitesinde suprakondiler lateral kapalı kama osteotomisinin iki farklı tespit yöntemi(2009) Kalacı, Aydıner; Özkan, Cenk; Yanat, Ahmet Nedim; Öney, Tayfun; Sever, Gökhan; Doğramacı, YunusAmaç: Erişkin kubitus varus deformitesi için uygulanan transvers osteotominin stabilizasyonunda Kirschner teli (K-teli) ya da Y plakla tespit edilen iki farklı yöntemin sonuçları gözden geçirildi. Hastalar ve yöntemler: On altı asker hasta askeri hastanede distal humerusta kubitus varus deformitesi için lateral kapalı kama osteotomisi ile tedavi edildi. Osteotomi için iki farklı tespit yöntemi kullanıldı. İlk beş hastada osteotomiler K-telleri kullanılarak tespit edildi. Bu beş hastada düzelme kaybı ve tellerin gevşeme sorunuyla karşılaşıldığından, diğer hastalarda tespit için Y plakları uygulandı. Bulgular: Kirschner teli grubunda üç ve Y plakla tespit uygulanan grupta bir hastada kötü sonuç alındı. Lateral kapalı kama osteotomisi teknik olarak kolaydır ve üç planlı deformite düzeltmeye izin verir. Hastalarımızda eşlik eden ulnar sinirin yer değiştirmesi ve triseps tendon atlaması osteotomiyle kendiliğinden düzeldi. Sonuç: Y plaklar, rijit tespit sağlamakla birlikte erken aktif harekete izin verir ve tespit kaybı veya implant yetmezliği gibi olası ilişkili komplikasyonları önler.Öğe Giant-cell tumor of the tendon sheath in the toe: A report of three cases(2008) Kalacı, Aydıner; Özkan, Cenk; Sevinç, Teoman Toni; Yanat, Ahmet NedimGiant-cell tumor of the tendon sheath is a benign, soft-tissue tumor usually arising from synovial cells of the tendon sheaths in the hand. Involvement of the toes is quite rare. We presented three patients including two women with ages 25 and 50 years, and one man aged 21 years, who underwent surgery for mass lesions originating from tendon sheaths of the toe. All the patients presented with a slightly painful soft tissue mass in the toe. Magnetic resonance imaging was not helpful in the differential diagnosis. Diagnosis of the tumors was made by histopathologic evaluation of completely excised lesions. No local recurrences were encountered during a mean follow-up of 18 months.Öğe Granular Cell Tumor of the Posterior Tibial Nerve as a Rare Cause of Heel Pain A Case Report(Amer Podiatric Med Assoc, 2009) Dogramaci, Yunus; Kalacı, Aydıner; Sevinc, Teoman Toni; Hakverdi, Sibel; Canda, Serefettin; Yanat, Ahmet NedimGranular cell tumor of peripheral nerves is extremely rare. We present the case of a patient with a well-capsulated intraneural granular cell tumor involving the posterior tibial nerve, who presented with chronic heel pain mimicking plantar fasciitis. Magnetic resonance imaging revealed a well-defined intraneural soft-tissue mass within the substance of the posterior tibial nerve. Histopathologic examination showed a granular cell tumor, which is extremley rare in the peripheral nerves. Heel pain is one of the common conditions handled by physicians, podiatrists, and orthopedic surgeons. Posterior tibial nerve lesions at the leg should be kept in mind in the differential diagnosis of patients with persistent heel and foot pain. Magnetic resonance imaging is a useful method in the anatomical evaluation of focal intraneural lesions. (J Am Podiatr Med Assoc 99(3): 254-257, 2009)Öğe Guyon tunnel syndrome secondary to excessive healing tissue in a child: a case report(Thieme Medical Publ Inc, 2008) Kalacı, Aydıner; Dogramaci, Yunus; Sevinc, Teoman Toni; Yanat, Ahmet NedimWe describe a case of an 8-year-old boy who developed a combined motor and sensory neuropathy of the distal ulnar nerve, after sustaining a superficial injury to the right flexor carpi ulnaris tendon at the level of the distal wrist crease. Guyon's canal syndrome is a very rare entity during childhood. We have noted only one prior description of this syndrome in the pediatric age group in a review of the English literature.Öğe Guyon's Canal Syndrome Secondary to Ulnar Artery Stenosis Caused by a Constricting Fibrous Band; a Rare Cause of Ulnar Nerve Compression(Ortadogu Ad Pres & Publ Co, 2011) Dogramaci, Yunus; Kalacı, Aydıner; Esen, Erdinc; Sevinc, Teoman T.; Emir, Anil; Yanat, Ahmet NedimGuyon's canal is not a common site of ulnar nerve compression at the wrist. Ganglia, lipoma, anomalous tendons and muscles, trauma related to an occupation, arthritis, and carpal bone fractures can cause ulnar nerve compression at the wrist. Ulnar nerve compression at Guyon's canal secondary to pathologic conditions involving the ulnar artery is also rare. Ulnar artery aneurysm, tortuous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. However, ulnar nerve compression at Guyon's canal by a constricting fibrous band has not been reported. The authors experienced a case of ulnar nerve compression at Guyon's canal by a constricting fibrous band and the patient's symptoms improved after surgical resection. This report is, to the best of our knowledge, the first on ulnar neuropathy in the Guyon's canal caused by a constricting fibrous band of the ulnar artery. We can not easily predict constricting fibrous band as a cause of ulnar nerve compression at Guyon's canal. However, if there is not an obvious etiology, we should consider a constricting fibrous band as another possible etiology.Öğe Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis(Springer, 2008) Kalaci, Aydmer; Yanat, Ahmet Nedim; Sevinc, Teoman Toni; Dogramaci, YunusInsufficiency fractures of femoral necks due to osteoporosis of unknown aetiology occurring coincidentally on both sides in young adults, have not been described in English literature so far. A 18-year-old young girl presented with a 3-month history of gradual onset of bilateral thigh pain and progressive inability to walk. At the first look, plain radiographs of both hips showed no gross abnormal findings other than some tips on reduced bone mineral density of the femoral necks. MRI was ordered upon a high suspicion of fracture and T1-weighed MRI showed a linear low signal on both femoral necks. Dual-energy X-ray absorptiometry of the lumbar spine and femoral neck showed low mineral density. She was treated surgically with in-situ internal fixation using cannulated screws. The bilateral thigh pain was resolved and walking started immediately after the treatment. Insufficiency fracture of the femoral neck due to osteoporosis should be kept in mind even in young adults complaining of atypical pain without evidence of unusual activities. We used both the terms of stress fracture and insufficiency (osteoporotic) fracture interchangeably as the mechanism of fractures resemble each other.Öğe Intracorporeal pneumatic shock application for the treatment of chronic plantar fasciitis: a randomized, double blind prospective clinical trial(Springer, 2010) Dogramaci, Yunus; Kalacı, Aydıner; Emir, Anil; Yanat, Ahmet Nedim; Gokce, AhmetPlantar fasciitis (PF) is a common clinical condition that usually resolves with non-operative treatments. Extracorporeal shock wave therapy (ESWT) has been used in the treatment of chronic PF not responding to other conservative measures; however, ESWT devices are expensive and available for daily practice in only few centers (In developing countries). A pneumatic lithotripter is a cheap and readily available device which uses pneumatic shock application for the intracorporeal lithotripsy. The aim of this study was to investigate the clinical efficacy of intracorporeal pneumatic shock therapy (IPST) application for the treatment of chronic PF using a cheap and readily available pneumatic lithotripter. A randomized, double-blind, placebo-controlled study was conducted. A total of 50 patients with clinically and radiologically confirmed PF were randomly allocated to either an active- (treatment) (n = 25) or inactive (placebo) (n = 25) group. Under local anesthesia and posterior tibial nerve block, a rigid probe was directly introduced into the calcaneal spur under fluoroscopic control; a standard protocol of 1,000 shock was applied during a single session into the calcaneal spur. The main outcome measure was the patients' subjective assessment of pain by means of a Visual Analog Scale (VAS) and the Roles and Maudsley Score before the treatment and 6 months later. At the 6 months, the rate of successful outcomes (excellent + good results) in the treatment group (92%) were significantly higher comparing to the control group (24%) (P < 0.001). Heel pain measured 6 months after using the VAS were 2.04 +/- A 1.67 in treatment group and 7.16 +/- A 1.57 in control group as compared to 8.92 +/- A 1.22 and 9.12 +/- A 1.23 before the commencement of the treatment. No complications attributable to the procedure such as rupture of the planter fascia, hematoma, or infection were observed during the study. This pilot study showed that IPST is an effective and safe method of treatment of patients with chronic PF not responding to conservative measures. IPST application should be considered before surgical intervention when the extracorporeal shock devices are not available for daily practice. However, further evaluation of this novel treatment is necessary to understand the exact mechanism of action.Öğe Intraneural hemangioma of the median nerve: A case report(Thieme Medical Publ Inc, 2008) Dogramaci, Yunus; Kalacı, Aydıner; Sevinc, Teoman Toni; Yanat, Ahmet NedimHemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.
