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Guyon's Canal

Zahir T Fadel, Osama A Samargandi, David T Tang
BACKGROUND: Compression neuropathy of the ulnar nerve at the Guyon canal is commonly seen by hand surgeons. Different anatomical variations of structures related to the Guyon canal have been reported in the literature. A thorough knowledge of the normal contents and possible variations is essential during surgery and exploration. OBJECTIVES: To review the recognized anatomical variations within and around the Guyon canal. METHODS: This study is a narrative review in which relevant papers, clinical studies, and anatomical studies were selected by searching electronic databases (PubMed and EMBASE)...
May 2017: Plastic Surgery
Christopher Pivec, Tarvo Sillat, Thomas Moritz, Georg Riegler, Josif Nanobachvili, Gerd Bodner
No abstract text is available yet for this article.
October 2017: Ultraschall in der Medizin
Fan Zhang, Yuranga Weerakkody, Patrik Tosenovsky
Hypothenar hammer syndrome (HHS) is an uncommon cause of unilateral Raynaud's phenomenon, splinter haemorrhages and hypothenar weakness. The typical patient is a male blue-collar worker who uses their hypothenar eminence to hammer objects as part of their work. The distal ulnar artery beyond Guyon's canal is superficial and vulnerable to blunt trauma. CTA and MRA are common initial investigations and can suggest the diagnosis. DSA is the gold standard imaging modality and offers therapeutic opportunities. Management is controversial, but unless there is critical digital ischaemia, conservative treatment is first line...
September 13, 2017: Journal of Medical Imaging and Radiation Oncology
YongSeok Nam, SeungHwan Hwang, SuRak Eo
Anomalous hypothenar muscles in the wrist are relatively common with 47% prevalence, and their possible consequences associated with Guyon's canal are well known. The accessory of the abductor digiti minimi muscle (ADM) is known to be one of the causes of ulnar tunnel syndrome or ulnar artery thrombosis. A unique ADM was found in the volar wrist region of an 87-year-old male cadaver passing through Guyon's canal.
August 2017: Journal of Wrist Surgery
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
February 15, 2017: Instructional Course Lectures
Magdalena Lewańska, Jolanta Walusiak-Skorupa
OBJECTIVES: Association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment at wrist remains controversial. The aim of the study has been to investigate the prevalence of Guyon's canal syndrome amongst patients diagnosed with the CTS, occupationally exposed to repetitive wrist movements. MATERIAL AND METHODS: The retrospective analysis of 310 patients (268 females, 42 males) representing the mean age of 52±7 years old hospitalized for the suspected occupational CTS was performed...
December 30, 2016: International Journal of Occupational Medicine and Environmental Health
Charles H Mitchell, Laura M Fayad, Shivani Ahlawat
Digital nerves are intrinsic to the sensory and motor function of the hand. These nerves represent the terminal ramifications of the ulnar, median, and radial nerves and are located distal to the carpal tunnel and Guyon canal. With magnetic resonance imaging, traumatic and nontraumatic abnormalities of the digital nerves can be shown with high contrast as well as high spatial resolution. Digital nerve abnormalities are most commonly posttraumatic in nature; however, infection, inflammatory, vascular malformations, and neoplasms can rarely occur...
March 6, 2017: Current Problems in Diagnostic Radiology
I González Pérez, F Corella Montoya, I Casado Fariñas
We present a case of an unusual cause of ulnar pain on a 9-year-old patient. The patient had pain on the ulnar side of the wrist after a fall. MRI showed a poorly defined lesion on the ulnar nerve at Guyon's canal. The initial diagnosis was traumatic neuropathy. Following conservative treatment of symptoms for one year, the pain started again. Therefore, a new MRI was performed where progression of the lesion was observed. Excision of the lesion was performed and the specimen sent for pathologic analysis. The diagnosis was of microcystic lymphatic malformation...
June 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Paweł Depukat, Brandon Michael Henry, Patrick Popieluszko, Joyeeta Roy, Ewa Mizia, Tomasz Konopka, Krzysztof A Tomaszewski, Jerzy A Walocha
OBJECTIVES: The goal of our study was to analyze the prevalence of variations, branching patterns, and histology of the ulnar nerve (UN) in Guyon's canal to address its importance in hand surgery, particularly decompression of the UN. METHODS: Fifty fresh cadavers were dissected bilaterally, and the nerve in the area of Guyon's canal was visualized. Samples for histology were also taken and prepared. The collected data were then analyzed. RESULTS: Morphometric measurements of the hands and histological studies were not found to have significant differences when compared by left or right side or by sex...
February 2017: Archives of Orthopaedic and Trauma Surgery
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
January 2017: Journal of the American Academy of Orthopaedic Surgeons
I Jiménez, F Manguila, M Dury
Hypothenar hammer syndrome is an uncommon injury of the ulnar artery in its passage through Guyon's canal, and has been associated with repetitive trauma. Its diagnosis requires of a high level of suspicion and a careful clinical interview. The appropriate treatment is not well defined in the literature, ranging widely from medical treatment to reconstructive surgery. A clinical case is presented of a 52 year-old healthy male, who presented with numbness of his fourth and fifth fingers after a trauma at the hypothenar eminence...
November 11, 2016: Revista Española de Cirugía Ortopédica y Traumatología
Anders Seldén, Fatin Hermiz, Bengt Östlund
Hypothenar hammer syndrome is a possibly underdiagnosed but treatable cause of Raynaud's phenomenon and hand ischemia elicited by thombosis or aneurysm secondary to acute or chronic blunt trauma to the ulnar artery at the level of Guyon's canal. This paper provides a summary of the condition with some emphasis on prophylactic and therapeutic aspects.
October 7, 2016: Läkartidningen
Mario James Ciani, Vicki LaFay, Gioia Ciani, Paul Carey, Nata Parnes
A routine cadaver dissection revealed a noteworthy anomalous muscle in the distal anterior forearm. Clinicians should be aware of this finding and consider it as a differential diagnosis in patients with wrist disorders such as ulnar tunnel syndrome from occlusion of the ulnar canal. A space-occupying lesion, such as the anomalous muscle found in this dissection, is an important potential source of ulnar canal obstruction.
October 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Michael John McCleave
A 43-year-old female is presented who underwent a two-stage tendon reconstruction and developed a low ulnar nerve palsy postoperatively. Exploration found that the tendon graft was passing through Guyon's canal and that the ulnar nerve was divided. This is a previously unreported complication. The reconstruction is discussed, the literature reviewed and a guide is given on how to identify the correct tissue plane when passing a tendon rod.
October 2016: Journal of Hand Surgery Asian-Pacific Volume
Sho Kohyama, Toshikazu Tanaka, Eriko Okano, Takaji Yanai, Naoyuki Ochiai
Lipofibromatous hamartoma (LFH) is a rare condition of the peripheral nerves that typically affects the median nerve. To the best of our knowledge, this is the first report of LFH of both, the median and ulnar nerves, at the wrist of a 63-year-old female patient. The patient presented to our hospital with a 40-year history of pain, numbness, and dysesthesia affecting all fingers of her left hand. Atrophy of the thenar muscles and the first dorsal interosseous was observed upon physical examination. Imaging studies and a surgery revealed that the patient's median and ulnar nerves were significantly enlarged, confirming the LFH diagnosis...
February 2016: Journal of Hand Surgery Asian-Pacific Volume
Laura S Humphries, Daniel A Baluch, Lukas M Nystrom, Dariusz Borys, Michael S Bednar
BACKGROUND: Metastatic solid tumors to the hand and peripheral nerves are exceedingly rare independent occurrences. Their occurrence together has never been reported in the literature. METHODS: We present a case report of a 69 year old male with a previous history of renal cell carcinoma (RCC) presenting with a rapidly-growing painful mass located at the right volar ulnar wrist, found to have endoneural solid tumor metastatic RCC to the ulnar nerve. RESULTS: Preoperative MRI imaging of the wrist revealed a heterogeneous mass on the volar aspect of the wrist extending along the length of the ulnar artery and nerve to the level of Guyon's canal...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
Soo-Young Hu, Jin-Gyu Choi, Byung-Chul Son
Although the musculoskeletal injuries associated with break-dancing which is gaining more popularity among adolescent and young people has been reported, the report regarding a peripheral nerve injury associated with breakdance is scarce. We report a rare case of a young amateur break-dancer, 'b-boy' who suffered from a painful paresthesia in his left hand, later diagnosed as type III Guyon's canal syndrome. A 23-year-old, right handed college man presented with a tenderness over the left hypothenar eminence and painful paresthesia over the ring and little fingers of 3 months duration...
October 2015: Korean Journal of Neurotrauma
Ozan Volkan Yurdakul, Nilgün Mesci, Yilmaz Çetinkaya, Duygu Geler Külcü
BACKGROUND AND PURPOSE: We determined the reliability of ultrasonography (US) measurements for diagnosing carpal tunnel syndrome (CTS) and their correlation with symptom duration and electrophysiology findings. We determined whether the ratio of the median-to-ulnar cross-sectional areas (CSAs) can support CTS diagnoses. METHODS: The pisiform CSA (CSA(pisiform)), swelling ratio (SR), palmar bowing, and CSA(pisiform)/ulnar CSA (CSA(ulnar)) measurements made in two subgroups of CTS patients (having sensory affection alone or having both sensory and motor affection) were compared with controls...
July 2016: Journal of Clinical Neurology
Christopher J Dy, Susan E Mackinnon
Ulnar neuropathy is commonly encountered, both acutely after elbow trauma and in the setting of chronic compression neuropathy. Careful clinical evaluation and discerning evaluation of electrodiagnostic studies are helpful in determining the prognosis of recovery with nonoperative and operative management. Appreciation of the subtleties in clinical presentation and thoughtful consideration of the timing and type of surgical intervention are critical to optimizing outcomes after treatment of ulnar neuropathy...
June 2016: Current Reviews in Musculoskeletal Medicine
Luyao Shen, Sulabha Masih, Dakshesh B Patel, George R Matcuk
Ulnar neuropathy is a common and frequent reason for referral to hand surgeons. Ulnar neuropathy mostly occurs in the cubital tunnel of the elbow or Guyon's canal of the wrist, and it is important for radiologists to understand the imaging anatomy at these common sites of impingement. We will review the imaging and anatomy of the ulnar nerve at the elbow and wrist, and we will present magnetic resonance imaging examples of different causes of ulnar neuropathy, including trauma, overuse, arthritis, masses and mass-like lesions, and systemic diseases...
March 2016: Clinical Imaging
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