Ulnar tunnel syndrome
Ulnar tunnel syndrome | |
---|---|
Other names | Guyon's canal syndrome |
Depiction of classic ulnar sensory distribution, including ulnar-4th and 5th fingers. Note that this diagram does not portray hand muscles affected by ulnar neuropathy. | |
Specialty | Orthopedic surgery |
Ulnar tunnel syndrome, also known as Guyon's canal syndrome or Handlebar palsy, is
Causes
Ulnar neuropathy at the wrist is often associated with a mass such as a ganglion cyst or thrombosis or aneurysm of the ulnar artery.[3] The role of activities and exposure is less certain.
Diagnosis
Classification
Ulnar tunnel syndrome may be characterized by the location or zone within the Guyon's canal at which the ulnar nerve is compressed. The nerve divides into a superficial sensory branch and a deeper motor branch in this area. Thus, Guyon's canal can be separated into three zones based on which portion of the ulnar nerve are involved. The resulting syndrome results in either muscle weakness or impaired sensation in the ulnar distribution.[1]
Location | Symptoms | Associations | |
Zone 1 | Proximal (prior to ulnar nerve bifurcation) | Mixed motor & sensory | Ganglia & hook of hamate fractures |
Zone 2 | Surrounding deep motor branch ulnar nerve | Motor only | Ganglia & hook of hamate fractures |
Zone 3 | Surrounding superficial sensory branch of ulnar nerve | Sensory only | Ulnar artery pathology |
Zone 2 type syndromes are most common, while Zone 3 are least common.
Treatment
The role of gloves which help protect the ulnar nerve from compression is unclear. Palsy of the ulnar motor nerve isolated to the wrist is treated with operative decompression, often with concomitant ganglion excision. The surgery is to divide the volar carpal ligament which forms the roof of Guyon's canal, thereby reducing compression on the ulnar nerve.[4][5]
See also
- Cubital tunnel syndrome
- Jean Casimir Félix Guyon
- Ulnar claw
References
Further reading
- Slane, Josh; Timmerman, Mark; Ploeg, Heidi-Lynn; Thelen, Darryl G. (2011). "The influence of glove and hand position on pressure over the ulnar nerve during cycling". Clinical Biomechanics. 26 (6): 642–8. PMID 21458120.
- Maimaris, C; Zadeh, H G (1990). "Ulnar nerve compression in the cyclist's hand: Two case reports and review of the literature". British Journal of Sports Medicine. 24 (4): 245–6. PMID 2097022.
- Rehak, David C. (Summer 2003). "Cyclist's Hands: Overcoming overuse injuries". Hughston Health Alert. Hughston Clinic.
- Bledsoe, Jim. "Cycling injuries - handlebar palsy". Sports Injury Bulletin.
- US patent 6845514, Yao, Joseph, "Protective device for the median and ulnar nerves", issued January 25, 2005