Carpal Tunnel Syndrome in Young Patients Caused by Anomalous Median Nerve and Aberrant Muscle: A Case Series.
- 1Department of Orthopaedics, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.
Abstract
Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity, typically affecting middle-aged and elderly individuals. Occurrence in adolescents or young adults without identifiable systemic risk factors is uncommon and often indicates an underlying structural cause. Anatomical variations, such as anomalous muscle bellies or median nerve abnormalities can reduce the space within the carpal tunnel and lead to symptomatic nerve compression. We present a series of four young patients aged 15-27 years who presented with symptoms suggestive of CTS without conventional risk factors. All patients demonstrated positive clinical provocative tests and electrophysiological evidence of median nerve compression. Imaging, where performed, suggested anatomical abnormalities within the carpal tunnel. Surgical exploration identified aberrant muscle bellies associated with median nerve compression; bifid median nerve and persistent median artery were also identified among the reported anatomical findings. All patients underwent open carpal tunnel release, with management of the aberrant muscle determined intraoperatively. Post-operative recovery was clinically favorable during the available short-term follow-up. Anatomical variations, such as aberrant muscle bellies and median nerve variants should be considered in young patients presenting with CTS symptoms, particularly when conventional risk factors are absent. In selected patients, imaging and careful intraoperative assessment may help identify structural contributors and guide individualized surgical management. Given the small case series and lack of a comparator, these observations should be considered hypothesis-generating rather than definitive.
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BibTeX
@article{lingaiah2026carpal,
title = {{Carpal Tunnel Syndrome in Young Patients Caused by Anomalous Median Nerve and Aberrant Muscle: A Case Series.}},
author = {Purushotham Lingaiah and M R Bhargavi and Sandeepan Dash and Devendra Moturu and A R Nataraj},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8488},
url = {https://europepmc.org/article/MED/42997116},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Carpal Tunnel Syndrome in Young Patients Caused by Anomalous Median Nerve and Aberrant Muscle: A Case Series.
AU - Purushotham Lingaiah
AU - M R Bhargavi
AU - Sandeepan Dash
AU - Devendra Moturu
AU - A R Nataraj
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8488
UR - https://europepmc.org/article/MED/42997116
AB - Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity, typically affecting middle-aged and elderly individuals. Occurrence in adolescents or young adults without identifiable systemic risk factors is uncommon and often indicates an underlying structural cause. Anatomical variations, such as anomalous muscle bellies or median nerve abnormalities can reduce the space within the carpal tunnel and lead to symptomatic nerve compression. We present a series of four young patients aged 15-27 years who presented with symptoms suggestive of CTS without conventional risk factors. All patients demonstrated positive clinical provocative tests and electrophysiological evidence of median nerve compression. Imaging, where performed, suggested anatomical abnormalities within the carpal tunnel. Surgical exploration identified aberrant muscle bellies associated with median nerve compression; bifid median nerve and persistent median artery were also identified among the reported anatomical findings. All patients underwent open carpal tunnel release, with management of the aberrant muscle determined intraoperatively. Post-operative recovery was clinically favorable during the available short-term follow-up. Anatomical variations, such as aberrant muscle bellies and median nerve variants should be considered in young patients presenting with CTS symptoms, particularly when conventional risk factors are absent. In selected patients, imaging and careful intraoperative assessment may help identify structural contributors and guide individualized surgical management. Given the small case series and lack of a comparator, these observations should be considered hypothesis-generating rather than definitive.
SN - 2250-0685
SN - 2321-3817
ER -