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Guyon's Canal

I González Pérez, F Corella Montoya, I Casado Fariñas
We present a case of an unusual cause of ulnar pain on a 9 years 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 Guyońs 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 were 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...
March 22, 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
Bin Wang, Jianfeng Zhang, Gang Li, Zhigang Zhang
This report presents a rare case of a 41-year-old woman with decreased sensation and weakness of grip of her left hand. On examination she had a well-defined mass on the ulnar-volar aspect of the wrist. Magnetic resonance imaging showed a focal nodular mass in Guyon's canal. Examination showed that the mass, 2.1 × 1.1 × 1.0 cm in size, originated in the proximal portion of the canal and was loosely associated with the tendon sheath of the flexor carpi ulnaris. The mass was removed and Guyon's canal released...
August 2016: Journal of Plastic Surgery and Hand Surgery
Sang-Uk Lee, Min-Wook Kim, Jae Min Kim
Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel...
January 2016: Journal of Korean Neurosurgical Society
Antonios Kerasnoudis
INTRODUCTION: The aim of this case study is to describe the use of nerve ultrasound to visualize the morphological changes that occur during conduction velocity alterations after strenuous exercise. METHODS: A 32-year-old, healthy runner underwent clinical, electrophysiological, and ultrasound evaluation 24 hours before, 30 minutes after, and 24 hours after a marathon. RESULTS: An increase in motor conduction velocity of the median, ulnar, radial, and tibial nerves and sensory conduction velocity of the median and ulnar nerves was found between pre- and post-marathon studies...
February 2016: Muscle & Nerve
Sara Sulaiman, Roger Soames, Clare Lamb
The ulnar nerve (UN) was classically described as supplying most of the intrinsic muscles of the hand, and the cutaneous innervation of the ulnar one and half digits, by dividing into superficial sensory and deep motor branches in Guyon's canal. Variations of this pattern have been reported in the literature. This study investigated the cutaneous distribution of the UN in the palm following the dissection of 144 cadaveric hands. The UN was examined and the distances from branching points of the superficial branch to the proximal edge of the pisiform were measured...
November 2015: Clinical Anatomy
Kristen M Davidge, Gil Gontre, David Tang, Kirsty U Boyd, Andrew Yee, Marci S Damiano, Susan E Mackinnon
BACKGROUND: The Scratch Collapse Test (SCT) is used to assist in the clinical evaluation of patients with ulnar nerve compression. The purpose of this study is to introduce the hierarchical SCT as a physical examination tool for identifying multilevel nerve compression in patients with cubital tunnel syndrome. METHODS: A prospective cohort study (2010-2011) was conducted of patients referred with primary cubital tunnel syndrome. Five ulnar nerve compression sites were evaluated with the SCT...
September 2015: Hand: Official Journal of the American Association for Hand Surgery
Mitsuhiko Nanno, Takuya Sawaizumi, Norie Kodera, Yuji Tomori, Shinro Takai
PURPOSE: The purpose of this study was to describe and evaluate the detailed anatomic locations and areas of ligamentous attachments and paths of the transverse carpal ligament (TCL) on a three-dimensional (3-D) surface model. METHODS: Ten fresh-frozen cadaver wrists were used to dissect and identify the TCL. Their ligament attachments and whole bone surfaces were digitized three-dimensionally and their areas evaluated. The attachments of each ligament were represented in a model combining CT surfaces overlaid by a digitized 3-D surface, and were also visually depicted with a different color for each on 3-D images of the bones...
2015: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
J Zhang, N Liu, Y W Wang, Z C Zhang, L N Zheng, J Zhu
Many carpal tunnel syndrome (CTS) patients have symptoms in both the median and ulnar digits more frequently than in the median digits alone. This is possibly because of close anatomical contiguity of the carpal tunnel and Guyon's canal, and the high pressure may also affect the latter, causing indirect compression of ulnar nerve fibers. Thus, we evaluated the functional status of the ulnar nerve in patients with CTS in order to investigate the relationship between ulnar nerve impairment and sensory symptoms of the ulnar territory...
2015: Genetics and Molecular Research: GMR
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