Ulnar Nerve Compression in Guyon’s Canal Due to a Haemangioma of the Ulnar Artery

Dentre os fatores que podem desencadear a compressão do canal de Guyon inclui-se o aneurisma da artéria ulnar. Uma das abordagens cirúrgicas é a reconstrução microcirúrgica através da ressecção e arteriorrafia término-terminal ou enxerto venoso de interposição. O objetivo deste trabalho é relatar o caso de paciente que desenvolveu neuropatia do nervo ulnar secundária à presença de aneurisma da artéria ulnar no canal de Guyon. Foi realizada a descompressão cirúrgica através de uma abertura do canal e a ressecção do segmento lesionado. A artéria ulnar foi reconstruída através da anastomose término-terminal microcirúrgica. O resultado foi o alívio completo dos sintomas no pós-operatório com manutenção do fluxo vascular. Descritores: Nervo Ulnar; Neuropatia Radial; Ferimentos e Lesões; Aneurisma. Referências Guyon F. Note sur une disposition anatomique proper à la face antérieure de la région du poignet et non encour décrite. Bulletins de la Societé anatomique de Paris, Second Series, 1861;6:184-86. Caetano EB, Brandi S, Oliveira Junior WM. Compressão do nervo ulnar no canal de Guyon por aneurisma verdadeiro: relato de um caso. Rev Bras Ortop. 2004;39(7):398-400. Shea JD, McClain EJ. Ulnar-nerve compression syndromes at and below the wrist. J Bone Joint Surg Am. 1969;51(6):1095-103. Rothkopf DM, Bryan DJ, Cuadros CL, May JW Jr. Surgical management of ulnar artery aneurysms. J Hand Surg Am. 1990;15(6):891-97. Harris EJ Jr, Taylor LM Jr, Edwards JM, Mills JL, Porter JM. Surgical treatment of distal ulnar artery aneurysm. Am J Surg. 1990;159(5):527-30. Dethmers RS, Houpt P. Surgical management of hypothenar and thenar hammer syndromes: a retrospective study of 31 instances in 28 patients. J Hand Surg Br. 2005;30(4):419-23. Aguiar PH, Bor-Seng-Shu E, Gomes-Pinto F, Almeida- Leme RJ, Freitas ABR, Martins RS et al. Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases. Arq Neuro-Psiquiatr. 2001;59(1):106-11. Jose RM, Bragg T, Srivastava S. Ulnar nerve compression in Guyon's canal in the presence of a tortuous ulnar artery. J Hand Surg Br. 2006;31(2):200-2. Galati G, Cosenza UM, Sammartino F, Benvenuto E, Caporale A. True aneurysm of the ulnar artery in a soccer goalkeeper: a case report and surgical considerations. Am J Sports Med. 2003;31(3):457-58. Rothkopf DM, Bryan DJ, Cuadros CL, May JW Jr. Surgical management of ulnar artery aneurysms. J Hand Surg Am. 1990;15(6):891-97.

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Ulnar Nerve Compression in Guyon’s Canal in the Presence of a Tortuous Ulnar Artery

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.10.003 ◽

2006 ◽

Vol 31 (2) ◽

pp. 200-202 ◽

Cited By ~ 17

Author(s):

R. M. JOSE ◽

T. BRAGG ◽

S. SRIVASTAVA

Keyword(s):

Ulnar Nerve ◽

Ulnar Artery ◽

Nerve Compression ◽

Guyon’S Canal ◽

Ulnar Nerve Compression ◽

Guyon's Canal

A case of ulnar nerve compression in Guyon’s canal occurring in the presence of a tortuous ulnar artery in the canal is presented and the pathology and classification of ulnar nerve compression in Guyon’s canal discussed.

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Ulnar nerve compression secondary to ulnar artery false aneurysm at the Guyon's canal

The Journal Of Hand Surgery ◽

10.1016/s0363-5023(82)80077-4 ◽

1982 ◽

Vol 7 (2) ◽

pp. 137-139 ◽

Cited By ~ 41

Author(s):

Michael Kalisman ◽

Kenneth Laborde ◽

Thomas W. Wolff

Keyword(s):

Ulnar Nerve ◽

False Aneurysm ◽

Ulnar Artery ◽

Nerve Compression ◽

Guyon’S Canal ◽

Ulnar Nerve Compression ◽

Guyon's Canal

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Ulnar nerve compression secondary to traumatic false aneurysm at the Guyon's canal.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.33.887 ◽

1985 ◽

Vol 33 (3) ◽

pp. 887-890 ◽

Cited By ~ 1

Author(s):

Noriyuki Gunge ◽

Eiji Hirano ◽

Koutaro Imamura ◽

Takayoshi Suga ◽

Hiroaki Konishi

Keyword(s):

Ulnar Nerve ◽

False Aneurysm ◽

Nerve Compression ◽

Guyon’S Canal ◽

Ulnar Nerve Compression ◽

Guyon's Canal

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Ulnar nerve compression in Guyon's canal caused by calcinosis in scleroderma

The Journal Of Hand Surgery ◽

10.1016/0363-5023(91)90204-o ◽

1991 ◽

Vol 16 (4) ◽

pp. 739-741 ◽

Cited By ~ 20

Author(s):

Robert T. Thurman ◽

Pankaj Jindal ◽

Thomas W. Wolff

Keyword(s):

Ulnar Nerve ◽

Nerve Compression ◽

Guyon’S Canal ◽

Ulnar Nerve Compression ◽

Guyon's Canal

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No. 47 Syringomyelia Simulating Ulnar Nerve Compression in Guyon's Canal: A Case Report

PM&R ◽

10.1016/j.pmrj.2014.08.278 ◽

2014 ◽

Vol 6 (8) ◽

pp. S106

Author(s):

Luis Mauricio Mora Caro ◽

Cesar Forero ◽

Fernando Ortiz ◽

Alvaro Rodriguez

Keyword(s):

Case Report ◽

Ulnar Nerve ◽

Nerve Compression ◽

Guyon’S Canal ◽

Ulnar Nerve Compression ◽

Guyon's Canal

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Digital Traumatic Fistula and Arteriovenous Malformation in a Patient with Ulnar Nerve Compression Syndrome

Journal for Vascular Ultrasound ◽

10.1177/154431671704100103 ◽

2017 ◽

Vol 41 (1) ◽

pp. 18-23

Author(s):

Humberto Varjão de Oliveira ◽

Sergio X. Salles-Cunha

Keyword(s):

Ulnar Nerve ◽

Ulnar Artery ◽

Signs And Symptoms ◽

Nerve Compression ◽

Ulnar Nerve Compression ◽

Diastolic Flow ◽

Fourth Digit ◽

Fourth Finger ◽

Guyon's Canal ◽

Canal Syndrome

Objective —Ulnar nerve compression, the Guyon's canal syndrome, is more unusual than carpal tunnel disorders. An exceptional case of a patient with vascular and neurogenic signs and symptoms is described. Patient Presentation —A 26-year-old female physiotherapist presented with neurogenic and arteriovenous signs and symptoms involving the right hand. The patient described fourth finger and wrist pain with flexion, and pain and itching extending to arm and forearm. Sensations worsened when exposed to air conditioning. Enlarged vessels were noted in the medial aspect of the fourth digit; trauma occurred 8 years earlier during attempts to open a nail polish container. Methods —Color flow, duplex-Doppler ultrasonography (US) of the subclavian to digital vessels was performed using 3- to 13-MHz transducers. Interpretation focused on flow waveforms obtained with the hand open and closed, having the left extremity as reference. Thermography was performed with camera Flir 15, room temperature at 21°C (70°F) and relative humidity at 48%. Results —Right subclavian to digital arteries had high diastolic flow with opened hand. Hand closure interrupted diastolic flow except in the ulnar circulation to the fourth digit. Common digital arteries feeding digits 3–4 and 4–5 had significantly more diastolic flow than the artery feeding digits 2–3. Diastolic flow through a dilated ulnar artery despite hand closure was associated to a millimetric arteriovenous fistula in the fourth finger. Hyperthermia saturating at 35°C (95°F) showed channel-like images over the ulnar nerve and artery and fourth digit, compared with 20°C (68°F) for digit 2. Conclusions —US and thermography demonstrated high flow and hyperthermia associated with a fourth digit fistula and abnormal vessels, and ulnar artery dilatation likely associated with ulnar nerve injury. A coadjuvant diagnosis of Guyon's canal syndrome at the wrist was raised.

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