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Natroshvili T, Roorda A, van Doorn M, Foumani M. Uncommon Anatomical Causes of Ulnar Compression: A Narrative Review. Ann Plast Surg 2024; 92:557-563. [PMID: 38547123 DOI: 10.1097/sap.0000000000003919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Some patients develop ulnar nerve compression due to rare anatomical variations or malformations. The aims of this review are to provide a comprehensive overview of anatomical structures and variations that can cause ulnar nerve compression and to evaluate treatment options. METHODS Case reports and case series about rare cases of unusual ulnar nerve compression published from January 2000 until April 2022 were obtained from databases Embase, MEDLINE, and Web of Science. A total of 48 studies describing 64 patients were included in our study. RESULTS The following structures have proven to cause ulnar nerve compression: anconeus epitrochlearis, accessory abductor digiti minimi, vascular anomalies, palmaris longus, fibrous bands, and flexor carpi ulnaris. All cases except one have had a surgical release of the ulnar nerve resulting in diminished symptoms or complete recovery at follow-up. CONCLUSIONS In addition to considering common compression points, it is important to be aware that proximal compression symptoms, such as pain and a positive Tinel sign at the medial elbow, may be attributed to a hypertrophic AE or vascular anomaly. Distal compression symptoms encompass swelling, along with pain and a positive Tinel sign at the distal forearm. Various structures contributing to distal compression include an accessory abductor digiti minimi muscle, an accessory or anomalous palmaris longus muscle, or an accessory or hypertrophic flexor carpi ulnaris muscle. The occurrence of fibrous bands exhibits variability, manifesting in diverse locations across the arm.Level of Evidence: IV.
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Affiliation(s)
- Tinatin Natroshvili
- From the Department of Plastic, Reconstructive and Hand Surgery, Martini Hospital, Groningen
| | - Adam Roorda
- Department of Orthopedic Surgery, University Medical Centre Groningen, Groningen, Groningen
| | - Mats van Doorn
- Radboud University, Nijmegen, Gelderland, the Netherlands
| | - Mahyar Foumani
- From the Department of Plastic, Reconstructive and Hand Surgery, Martini Hospital, Groningen
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Li CW, Wu JCH, Lan CY, Lee CH, Huang RW, Lin CH, Hsu CC, Lin YT, Chen SH, Tang YB, Chen HC, Chen SH. Prospective outcome analysis of ulnar tunnel syndrome: Comparing traumatic versus non-traumatic etiologies. Asian J Surg 2023; 46:180-186. [PMID: 35305874 DOI: 10.1016/j.asjsur.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/14/2022] [Accepted: 03/03/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Ulnar tunnel syndrome (UTS) is relatively uncommon compared to the carpal tunnel or cubital tunnel syndromes. Few reports dedicated to the functional outcomes after surgical intervention of the UTS exist. Herein we compare the outcomes of patients with UTS of different etiologies. METHODS Patients diagnosed with UTS between 2016 and 2020 were recruited. Ulnar tunnel release was performed in all patients, along with other necessary osteosynthesis or reconstructive procedures in the traumatic group. Patients were followed-up every six months post-operatively. Outcomes measured include: objective evaluations, subjective questionnaires, records of clinical signs, and grading of the British Medical Research Council scale for intrinsic muscle strength. RESULTS 21 patients were recruited, and favorable results were noted in all of them after surgery. Traumatic UTS patients had a worse initial presentation than the non-traumatic cases, but had a greater improvement after surgery and yielded outcomes comparable with those of the patients without trauma. Patients with aberrant muscles in their wrists had better outcomes in some objective measurements than those without aberrant muscles. CONCLUSIONS Ulnar tunnel release improves the outcome of patients regardless of the etiology, especially in patients with trauma-induced UTS. Thus, a proper diagnosis of the UTS should be alerted in all patients encountering paresthesia in the ulnar digits, ulnar-sided pain, weakness of grip strength, or intrinsic weakness to ensure good outcomes.
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Affiliation(s)
- Chun-Wei Li
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - John Chung-Han Wu
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Ching-Yu Lan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Che-Hsiung Lee
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Ren-Wen Huang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Cheng-Hung Lin
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Chung-Chen Hsu
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Yu-Te Lin
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan
| | - Shih-Hsien Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Yueh-Bih Tang
- Department of Plastic Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Cosmetic Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Hung-Chi Chen
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Heng Chen
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University and College of Medicine, Taoyuan, Taiwan; Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
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Ramakrishnan G, Fontem RF, Sheth SU. Tortuous ulnar artery presenting as left distal forearm mass. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:430-432. [PMID: 32775848 PMCID: PMC7396824 DOI: 10.1016/j.jvscit.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022]
Abstract
Knowledge of anatomic variation in vasculature is critical to safe medical intervention as conduits vary in morphology, architecture, and course. Tortuosity is a common anatomic variant in certain arterial beds; however, its prevalence in ulnar arteries is not well documented in the literature. Here we report two cases of tortuous ulnar arteries in patients being evaluated for upper extremity hemodialysis access.
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Affiliation(s)
| | - Rodrigue F. Fontem
- Department of General Surgery, St. Luke's University Health Network, Bethlehem, Pa
| | - Sharvil U. Sheth
- Department of Vascular Surgery, St. Luke's University Health Network, Bethlehem, Pa
- Correspondence: Sharvil U. Sheth, MD, Department of Vascular Surgery, St. Luke's University Health Network, 3735 Nazareth St, Ste 206, Easton, PA 18045
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Isolated Compression of the Ulnar Nerve Motor Branch: A Case Series With 3 Unique Etiologies. Ann Plast Surg 2019; 80:529-532. [PMID: 29489540 DOI: 10.1097/sap.0000000000001406] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although ulnar neuropathies are commonly encountered, isolated involvement of the motor branch is exceedingly rare. Previous reports of this entity describe compression as the deep motor branch passes through the piso-hamate hiatus and the adductor pollicis hiatus. This case series described 3 cases of motor branch compression due to unique etiologies which resolved after surgery. METHODS A retrospective chart review identified patients with compression of the ulnar nerve motor branch. From these patients, 3 were selected with a unique etiology for compression. Patient demographics, objective and subjective findings, and pathology identified during surgery were recorded and analyzed. RESULTS Eight patients had compression of the ulnar nerve motor branch and 3 unique etiologies were selected; an intraneural ganglion, a constricting leash of vessels, and a series of compressing fibrous bands. All required surgery, and each patient had full resolution of symptoms by 1 year postoperatively. DISCUSSION Patients presenting with complaints of weakness with a positive Froment and Egawa signs but a negative Wartenberg sign and no sensory complaints can be a diagnostic dilemma. Compression of the ulnar nerve motor branch must be considered, and here we present 3 unique cases. Activity modification in those presenting early may be curative, although many ultimately require surgery. In the cases presented here, all patients experienced full resolution of their symptoms by 1 year after surgery.
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Rodrigues V, Rao MK, Nayak S, Kumar N. Looped and Tortuous Ulnar Artery - An Erratic Unilateral Vascular Presentation in the Proximal Forearm. J Clin Diagn Res 2016; 10:AD03-4. [PMID: 27504273 DOI: 10.7860/jcdr/2016/20771.7948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 05/06/2016] [Indexed: 11/24/2022]
Abstract
Precise and detailed knowledge of possible anatomical variations of the arterial pattern in the upper extremity is vital during reparative surgery in this region. Scientific literatures witnessed several reports on variant origin and branching pattern of ulnar artery. But report on looped and tortuous ulnar artery is lacking in the literature. We report here a unique case of ulnar artery having double loop at its commencement giving it an appearance of sigmoid shape and its undue tortuous course in the forearm. Such an unusual and unpredictable variation of ulnar artery is vulnerable for life threatening hemorrhage during clinical approaches. It could also lead to misinterpretation of CT scans as presence of tumours. Awareness on such exceptional anatomical discrepancy of ulnar artery is important to clinicians, neuroradiologists and radiologists in general.
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Affiliation(s)
- Vincent Rodrigues
- Senior Lecturer, Department of Preclinical Sciences, Faculty of Medical Sciences, University of West Indies, St. Augustine , Trinidad and Tobago, West Indies
| | - Mohandas Kg Rao
- Professor, Department of Anatomy, Melaka Manipal Medical College , Manipal Campus, Manipal University, Manipal, Karnataka, India
| | - Shivananda Nayak
- Professor, Department of Preclinical Sciences, Faculty of Medical Sciences, University of West Indies , St. Augustine, Trinidad and Tobago, West Indies
| | - Naveen Kumar
- Assistant Professor, Department of Anatomy, Melaka Manipal Medical College , Manipal Campus, Manipal University, Manipal, Karnataka, India
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Abstract
Ulnar neuropathy at or distal to the wrist, the so-called ulnar tunnel syndrome, is an uncommon but well-described condition. However, diagnosis of ulnar tunnel syndrome can be difficult. Paresthesias may be nonspecific or related to coexisting pathologies, such as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, C8-T1 radiculopathy, or peripheral neuropathy, which makes accurate diagnosis challenging. The advances in electrodiagnosis, ultrasonography, computed tomography, and magnetic resonance imaging have improved the diagnostic accuracy. This article offers an updated view of ulnar tunnel syndrome as well as its etiologies, diagnoses, and treatments.
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Affiliation(s)
- Shih-Heng Chen
- Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky
| | - Tsu-Min Tsai
- Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky.
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Abstract
Hand surgeons routinely treat carpal and cubital tunnel syndromes, which are the most common upper extremity nerve compression syndromes. However, more infrequent nerve compression syndromes of the upper extremity may be encountered. Because they are unusual, the diagnosis of these nerve compression syndromes is often missed or delayed. This article reviews the causes, proposed treatments, and surgical outcomes for syndromes involving compression of the posterior interosseous nerve, the superficial branch of the radial nerve, the ulnar nerve at the wrist, and the median nerve proximal to the wrist.
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Affiliation(s)
- Elisa J Knutsen
- Department of Orthopaedic Surgery, Washington University School of Medicine, Washington University, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA
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Abstract
Peripheral nerve entrapments are frequent. They usually appear in anatomical tunnels such as the carpal tunnel. Nerve compressions may be due to external pressure such as the fibular nerve at the fibular head. Malignant or benign tumors may also damage the nerve. For each nerve from the upper and lower limbs, detailed clinical, electrophysiological, imaging, and therapeutic aspects are described. In the upper limbs, carpal tunnel syndrome and ulnar neuropathy at the elbow are the most frequent manifestations; the radial nerve is less frequently involved. Other nerves may occasionally be damaged and these are described also. In the lower limbs, the fibular nerve is most frequently involved, usually at the fibular head by external compression. Other nerves may also be involved and are therefore described. The clinical and electrophysiological examination are very important for the diagnosis, but imaging is also of great use. Treatments available for each nerve disease are discussed.
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Affiliation(s)
- P Bouche
- Department of Clinical Neurophysiology Salpêtrière Hospital, Paris, France.
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Kollmer J, Bäumer P, Milford D, Dombert T, Staub F, Bendszus M, Pham M. T2-signal of ulnar nerve branches at the wrist in guyon's canal syndrome. PLoS One 2012; 7:e47295. [PMID: 23071777 PMCID: PMC3468548 DOI: 10.1371/journal.pone.0047295] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 09/11/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To evaluate T2-signal of high-resolution MRI in distal ulnar nerve branches at the wrist as diagnostic sign of guyon's-canal-syndrome (GCS). MATERIALS AND METHODS 11 GCS patients confirmed by clinical/electrophysiological findings, and 20 wrists from 11 asymptomatic volunteers were prospectively included to undergo the following protocol: axial T2-weighted-fat-suppressed and T1-weighted-turbo-spin-echo-sequences (3T-MR-scanner, Magnetom/Verio/Siemens). Patients were examined in prone position with the arm extended and wrist placed in an 8-channel surface-array-coil. Nerve T2-signal was evaluated as contrast-to-noise-ratios (CNR) from proximal-to-distal in ulnar nerve trunk, its superficial/sensory and deep/motor branch. Distal motor-nerve-conduction (distal-motor-latency (dml)) to first dorsal-interosseus (IOD I) and abductor digiti minimi muscles was correlated with T2-signal. Approval by the institutional review-board and written informed consent was given by all participants. RESULTS In GCS, mean nerve T2-signal was strongly increased within the deep/motor branch (11.7±4.8 vs.controls:-5.3±2.4;p = 0.001) but clearly less and not significantly increased in ulnar nerve trunk (6.8±6.4vs.-7.4±2.5;p = 0.07) and superficial/sensory branch (-2.1±4.9vs.-9.7±2.9;p = 0.08). Median nerve T2-signal did not differ between patients and controls (-9.8±2.5vs.-6.7±4.2;p = 0.45). T2-signal of deep/motor branch correlated strongly with motor-conduction-velocity to IOD I in non-linear fashion (R(2) = -0.8;p<0.001). ROC-analysis revealed increased nerve T2-signal of the deep/motor branch to be a sign of excellent diagnostic performance (area-under-the-curve 0.94, 95% CI: 0.85-1.00; specificity 90%, sensitivity 89.5%). CONCLUSIONS Nerve T2-signal increase of distal ulnar nerve branches and in particular of the deep/motor branch is highly accurate for the diagnostic determination of GCS. Furthermore, for the first time it was found in nerve entrapment injury that T2-signal strongly correlates with electrical-conduction-velocity.
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Affiliation(s)
- Jennifer Kollmer
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
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Abstract
Ulnar tunnel syndrome could be broadly defined as a compressive neuropathy of the ulnar nerve at the level of the wrist. The ulnar tunnel, or Guyon's canal, has a complex and variable anatomy. Various factors may precipitate the onset of ulnar tunnel syndrome. Patient presentation depends on the anatomic zone of ulnar nerve compression: zone I compression, motor and sensory signs and symptoms; zone II compression, isolated motor deficits; and zone III compression; purely sensory deficits. Conservative treatment such as activity modification may be helpful, but often, surgical exploration of the ulnar tunnel with subsequent ulnar nerve decompression is indicated.
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Affiliation(s)
- Abdo Bachoura
- The Philadelphia Hand Center, Philadelphia, PA 19107, USA
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12
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Malone PSC, Hutchinson CE, Kalson NS, Twining CJ, Terenghi G, Lees VC. Subluxation-related ulnar neuropathy (SUN) syndrome related to distal radioulnar joint instability. J Hand Surg Eur Vol 2012; 37:652-64. [PMID: 22193951 DOI: 10.1177/1753193411432707] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Ulnar neuropathy coexistent with distal radioulnar joint (DRUJ) instability has previously been observed in our practice. The aim of this study was to define this phenomenon and investigate the hypothesis that the cause of this intermittent, positional ulnar neuropathy is related to kinking of the ulnar nerve about the DRUJ. Ulna neuropathy was present in 10/51 (19.6%) of a historical cohort of patients who presented with DRUJ instability. Nine subsequent patients with DRUJ instability and coexistent ulnar neuropathy underwent 3-T magnetic resonance imaging to better understand the mechanism of the observed syndrome. Both 3D qualitative and quantitative analyses were used to assess the presence of nerve 'kinking', displacing the nerve from its normal course and causing nerve compression/distraction in the distal forearm and Guyon's canal. Results of the quantitative analysis were statistically significant (p < 0.05). The clinical features of the condition have been delineated and termed subluxation-related ulnar neuropathy or SUN syndrome. The imaging study was a level II diagnostic study.
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Affiliation(s)
- P S C Malone
- Blond McIndoe Laboratories, University of Manchester, Department of Reconstructive Plastic Surgery, University Hospital South Manchester, Wythenshawe, UK
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Tubbs RS, Deep A, Shoja MM, Mortazavi MM, Loukas M, Cohen-Gadol AA. The arcade of Struthers: An anatomical study with potential neurosurgical significance. Surg Neurol Int 2011; 2:184. [PMID: 22276238 PMCID: PMC3263005 DOI: 10.4103/2152-7806.91139] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 11/23/2011] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Significant controversy exists regarding the existence of the so-called arcade of Struthers and whether this structure is involved in some cases of proximal ulnar nerve entrapment. Therefore, the aim of the present study was to further elucidate this anatomy. METHODS Fifteen cadavers (30 sides) underwent dissection of the medial arm with special attention to the course of the ulnar nerve and its relationships to the soft tissues of this region. RESULTS We identified a thickening in the inferior medial arm that crosses the ulnar nerve and is consistent with the so-called arcade of Struthers in 86.7% of sides. On 57.7% of the sides, the arcade was found to be due to a thickening of the brachial fascia and was classified as a type I arcade. On 19.2% of the sides, the arcade was due to the internal brachial ligament and these were classified as type II arcades. On 23.1% of the sides, the arcade was due to a thickened medial intermuscular septum and these were classified as type III arcades. The mean length of the arcade was 4.3 cm and the distal end of the arcade was, on average, 6.8 cm above the medial epicondyle. Although the presence of an arcade of Struthers was slightly more common in female specimens, this did not reach statistical significance. However, arcades were found more often on right side (P < 0.001). CONCLUSIONS Based on our findings, the arcade of Struthers is an anatomical band of connective tissue in the medial distal arm that crosses the ulnar nerve. This structure was found in the majority of our specimens and may need to be evaluated in proximal ulnar neuropathies. We believe that past studies that have not observed the arcade and past studies with varied findings are due to the various definitions used for this anatomical structure. Using the classification system as demonstrated in the present study may make future communications regarding the arcade of Struthers more exact.
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Affiliation(s)
- R. Shane Tubbs
- Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, AL, USA
| | - Aman Deep
- Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, AL, USA
| | - Mohammadali M. Shoja
- Neuroscience Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, Grenada
| | - Aaron A. Cohen-Gadol
- Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, IN, USA
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Boughton O, Adds PJ, Jayasinghe JAP. The potential complications of open carpal tunnel release surgery to the ulnar neurovascular bundle and its branches: A cadaveric study. Clin Anat 2010; 23:545-51. [DOI: 10.1002/ca.20980] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Pai V, Harp A, Pai V. Guyon's canal syndrome: a rare case of venous malformation. J Hand Microsurg 2010; 1:113-5. [PMID: 23129944 DOI: 10.1007/s12593-009-0015-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 12/23/2008] [Indexed: 10/20/2022] Open
Abstract
This paper describes an unusual case of parasthesia in the medial two fingers of the hand in a 56-yearold lady. MRI suggested a space occupying lesion and on exploration this proved to be a venous malformation causing a pressure neuropathy of the ulnar nerve.
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Affiliation(s)
- Vasu Pai
- National Board [Orth], FICMR, FRACS MCh[Orth], Gisborne, New Zealand
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Kim SS, Kim JH, Kang HI, Lee SJ. Ulnar Nerve Compression at Guyon's Canal by an Arteriovenous Malformation. J Korean Neurosurg Soc 2009; 45:57-9. [PMID: 19242575 DOI: 10.3340/jkns.2009.45.1.57] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 12/29/2008] [Indexed: 11/27/2022] Open
Abstract
Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve compression at Guyon's canal by an arteriovenous malformation (AVM) and the patient's symptom was improved after surgical resection. We can not easily predict vascular lesion as a cause of ulnar nerve compression at Guyon's canal. However, if there is not obvious etiology, we should consider vascular lesion as another possible etiology.
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Affiliation(s)
- Sung Soo Kim
- Department of Neurosurgery, Eulji University School of Medicine, Seoul, Korea
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Ozdemir O, Calisaneller T, Altinors N. Compression of the ulnar nerve in Guyon's canal by an arteriovenous malformation. J Hand Surg Eur Vol 2007; 32:600-1. [PMID: 17950236 DOI: 10.1016/j.jhse.2007.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2006] [Revised: 03/16/2007] [Accepted: 04/02/2007] [Indexed: 02/03/2023]
Affiliation(s)
- Ozgur Ozdemir
- Department of Neurosurgery, Baskent University, Ankara, Turkey E-mail:
| | | | - Nur Altinors
- Department of Neurosurgery, Baskent University, Ankara, Turkey E-mail:
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