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Intraneural Heterotopic Ossification of a Digital Nerve

Department of Orthopedics, Tokushima University, Tokushima, Japan E-mail: hamada-yoshitaka{at}umin.ac.jp

Dear Sir,

A 21 year-old woman presented with a 5-month history of intermittent pain of the right index finger tip. On examination, there was severe tenderness on the radial side of her right index finger at the DIP joint level. A small tumour-like lesion with bony calcification was seen at the DIP level on plain X-ray (Fig 1) and on MRI. The site was explored under brachial block anaesthesia through a radial mid-lateral incision. The radial digital nerve was found to be elongated at the DIP joint level (Fig 2). This section of the nerve was resected and the 2 mm gap repaired by direct anastomosis with 10-0 nylon suture. After surgery, the pain completely resolved. The specimen was reported histologically to be similar to neuritis ossificans of the digital nerve (Isla et al., 2004), although zonal structuring was not clearly observed. The centre of the lesion consisted of bone tissue surrounded by infiltrating neutrophils, eosinophils and lymphocytes. The fascicle structure was positive for S100 protein and negative for MIB-1.

View larger version (63K): [in this window] [in a new window]   Fig 1 Posteroanterior and lateral plain X-rays showing a small bone fragment (arrows) on the radial side of the DIP joint.

View larger version (96K): [in this window] [in a new window]   Fig 2 Intraoperative photograph showing the radial digital nerve, which appeared elongated at the DIP joint level (arrow).

	References

Top References

 
Catalano F, Fanfani F, Pagliei A, Taccardo G (1992). A case of primary intraneural ossification of the ulnar nerve. Annales de Chirurgie de la Main et du Membre Superieur, 11: 157–162.[CrossRef][Medline] [Order article via Infotrieve]

Journal of Hand Surgery (European Volume), Vol. 32, No. 6, 715 (2007)
DOI: 10.1016/J.JHSE.2007.06.009


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This Article Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hamada, Y. Articles by Kasai, T. Search for Related Content PubMed Articles by Hamada, Y. Articles by Kasai, T. Social Bookmarking                         What's this?