Objective. The purpose of this study was to evaluate the reproducibility of median nerve cross-sectional area (CSA) measurements using the indirect method (ellipsoid formula) and the direct or tracing method. Methods. The median nerve CSA was measured in 22 wrists of patients with carpal tunnel syndrome by means of high-frequency sonography. Measurements were made at the level of the pisiform bone by a standardized sonographic examination protocol. Two observers with different levels of experience performed the measurements, independently and blinded. An analysis of reliability was carried out, and the concordance between the methods was determined with parametric statistical tests. Results. The results point to good reproducibility of the median nerve CSA measurements obtained by both methods, whether performed by an experienced observer or by an inexperienced observer after a short learning period. Conclusions. The results suggest sonography for median nerve CSA measurements is reproducible by either the direct or indirect method when a standardized sonographic examination protocol is used.

Objective: We present a 59-year-old male patient with a 6-month evolution lesion characterized by an increase in volume in the posterior region of the right thigh with expansive growth, pain of moderate intensity and limitation of gait. Clinical case: Magnetic resonance of the thigh that reports: "focal alteration within the thickness of the posterior superficial muscular plane, biceps femoris muscle short and long head, visible focal oval lesion, measuring approximately 10.44 cm × 7.3 cm with heterogeneous intensity, shows trabeculae, detritus and high intensity content". Drainage and biopsy report: malignant mesenchymal tumor. Tumor vascularization and suspected involvement of superficial branches in the deep femoral artery. With the improvement of the Malawer Sugarbaker surgical technique, the posterior septal tumor of the thigh was removed through a supine anteroposterior approach, vascular control, and cross surgical management of pathological anatomy. Adequate oncological resection with surgical result, evolution and satisfactory recovery. Conclusion: For large tumors that may or have been confirmed to have vascular involvement, modifying the classic technique of posterior thigh resection is a feasible and provable alternative method from a practical perspective, as it can better control tumor lesions during surgery. For large volume posterior chamber sarcoma with vascular involvement, it is recommended to adopt multidisciplinary management and utilize existing tools to personalize each clinical case.

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