UPPER EXTREMITY ISCHEMIA WITH FINGER NECR OSIS - CARPAL-TUNNEL SYNDROME OR THORACIC OUTLET SYNDROME

A 26-year-old male patient complained of pain and paraesthesia in the right upper extremity while working with the arm elevated After electr ophysiological diagnosis of a carpal-tunnel-syndrome the patient recei ved surgical treatment. Following this treatment he developed acral ne crosis at the fingers. Additional diagnostic effort let to the diagnos is of a thoracic-outlet-syndrome due to a cervical rib. This case repo rt and a review of the literature show that electrophysiological inves tigations alone can not differentiate the carpal-tunnel-syndrome from the thoracic-outlet-syndrome. Thus an operative release of a carpal-tu nnel should not be performed until the arterial perfusion of the upper extremity has been judged.