Surgical anatomy of the Guyon canal in children

2011 ◽  
Vol 7 (3) ◽  
pp. 286-289
Author(s):  
Marcus Alexandre Mendes Luz ◽  
Maria Julia Marques ◽  
Humberto Santo Neto
Keyword(s):  
Surgical Treatment ◽  
Ulnar Nerve ◽  
Light Microscope ◽  
Ulnar Artery ◽  
Surgical Anatomy ◽  
Flexor Retinaculum ◽  
Embedding Medium ◽  
Age Range ◽  
Canal Syndrome ◽  
Formalin Fixed

Object The anatomy of the Guyon canal is crucial for open and endoscopic surgeries for ulnar canal syndrome at the wrist level. It is also of interest for surgical treatment of carpal canal syndromes. Whereas the Guyon canal is largely described in adults, no studies exist in children. In the present study, the authors examined the Guyon canal in children. Methods Sectional anatomy was used. Thirty-two formalin-fixed cadavers (64 sides) were examined (age range 2–11 years). The hands were transversely cut into 2–3-mm-thick slices. Slices were placed in embedding medium, and transverse sections (10 μm thick) were stained with histological methods and photographed under a light microscope. Results The roof of the Guyon canal was attached to the flexor retinaculum laterally to the hamulus of the hamate bone. Thus, the radial boundary of the Guyon canal was lateral to the hamulus, which became part of the floor of the Guyon canal. An ulnar neurovascular bundle was found directly volar to the hamulus in 93.8% of the cases and slightly medial to the hamulus (to the ulnar side) in 6.2% of the cases. Proximally, the ulnar artery and nerve were sustained by the flexor retinaculum in direct apposition to the carpal canal. Conclusions In children, the Guyon canal displays an anatomical particularity regarding the topography of the ulnar artery and nerve that may be of relevance for intraoperative orientation and endoscopic navigation to avoid lesions to the ulnar nerve and artery in carpal and Guyon canal syndromes.

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

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.

scholarly journals Síndrome do canal de Guyon por aneurisma da artéria ulnar: relato de caso

2020 ◽  
Vol 9 (6) ◽  
pp. 648-650
Author(s):  
Luis Guilherme Rosifini Alves Rezende ◽  
Letícia de Freitas Leonel ◽  
Filipe Jun Shimaoka ◽  
Gunter Shin Iti Takamori Shimabukuro ◽  
Luiz Garcia Mandarano-Filho ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Surgical Management ◽  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Nerve Compression ◽  
Guyon’S Canal ◽  
True Aneurysm ◽  
Ulnar Nerve Compression ◽  
Guyon's Canal ◽  
Canal Syndrome

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.

scholarly journals Surgical management of Guyon's canal syndrome, an ulnar nerve entrapment at the wrist: report of two cases

2001 ◽  
Vol 59 (1) ◽  
pp. 106-111 ◽  
Author(s):  
Paulo Henrique Aguiar ◽  
Edson Bor-Seng-Shu ◽  
Fernando Gomes-Pinto ◽  
Ricardo Jose de Almeida- Leme ◽  
Alexandre Bruno R. Freitas ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Nerve Entrapment ◽  
Guyon’S Canal ◽  
Ulnar Nerve Entrapment ◽  
Anatomical Classification ◽  
Common Causes ◽  
Guyon's Canal ◽  
Canal Syndrome

Guyon's canal syndrome, an ulnar nerve entrapment at the wrist, is a well-recognized entity. The most common causes that involve the ulnar nerve at the wrist are compression from a ganglion, occupational traumatic neuritis, a musculotendinous arch and disease of the ulnar artery. We describe two cases of Guyon's canal syndrome and discuss the anatomy, aetiology, clinical features, anatomical classification, diagnostic criteria and treatment. It is emphasized that the knowledge of both the surgical technique and anatomy is very important for a satisfactory surgical result.

scholarly journals Ulnar Nerve Compression in Guyon’s Canal by Ulnar Artery Cystic Adventitial Disease: A Case Report

2021 ◽  
pp. 33-38
Author(s):  
João Ribeiro Afonso ◽  
João Carvas ◽  
Miguel Quesado ◽  
João Vasconcelos ◽  
José Vidoedo ◽  
...  
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Popliteal Artery ◽  
Ulnar Artery ◽  
Work Activities ◽  
Ulnar Nerve Compression ◽  
History Of ◽  
Mucinous Cyst

Cystic adventitial disease is a condition where mucinous cyst(s) develop within the adventitia of blood vessels, especially arteries. The most affected vessel is the popliteal artery while the upper limb vasculature is seldom involved. To our knowledge, there are only 2 articles reporting this disease in the ulnar artery. We present a case of a 52-year-old female patient, a manual worker in a clothing factory, with a month history of increasing pain in her right wrist and gradual weakness that incapacitated her for work activities. She was finally treated surgically and an adventitial cyst of the ulnar artery compressing the ulnar nerve was diagnosed.

Chimerization of Monitor Flap in a Vascularized Ulnar Nerve Flap Is an Efficient Way for Vascularity Monitoring and the Reinnervation Checkup after Its Transplantation

2021 ◽  
Author(s):  
Lisa Wen-Yu Chen ◽  
Abraham Zavala ◽  
David Chwei-Chin Chuang ◽  
Johnny Chuieng-Yi Lu ◽  
Tommy Nai-Jen Chang
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Perioperative Complications ◽  
Microvascular Complications ◽  
Demographic Data ◽  
Skin Flap ◽  
Ulnar Artery ◽  
Functional Improvement ◽  
External Compression ◽  
Skin Paddle

Abstract Background Free vascularized ulnar nerve flaps (VUNF) are effective method for long nerve defects reconstruction. However, the monitorization of its microvascular circulation and the nerve regrowth can be challenging since it is usually designed as a buried flap. We designed a skin paddle based on a septocutaneous perforator from the ulnar artery that can be dissected and raised in conjunction with the vascularized ulnar nerve flap, which aims to improve postoperative monitorization to optimizing the clinical results. Methods We retrospectively reviewed 10 cases with long nerve defects who underwent reconstruction using VUNF between June 2018 and June 2019, including eight acute brachial plexus injuries, 1 multiple nerve injury due to a rolling machine accident, and 1 sequalae of nerve injury after arm replantation. All the demographic data, surgical details, outcomes, and perioperative complications were recorded. Results We evaluated 10 male patients, with a mean age of 34 ± 16 years. Cases included 5 antegrade, 4 retrograde, and 1 U-shaped VUNF. All chimeric skin paddles survived, and all of the underlying nerves presented with adequate circulation and functional improvement. There were no intraoperative or microvascular complications. One skin paddle had a transitory postoperative circulation compromise due to external compression (bandage) which resolved spontaneously after pressure release. Conclusion VUNF chimerization of a septocutaneous perforator skin flap is a relatively easy and efficient method for postoperative monitorization of the nerve’s microvascular circulation as well as beneficial for postoperative Tinel’s sign checkup to confirm the success of the nerve coaptation. The outcome is potentially improved.

Surgical Treatment of Tardy Ulnar Nerve Palsy

1990 ◽  
Vol 25 (3) ◽  
pp. 772
Author(s):  
Ik Dong Kim ◽  
Poong Taek Kim ◽  
Byung Chul Park ◽  
Young Wook Choi ◽  
Young Goo Lyu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Ulnar Nerve ◽  
Nerve Palsy ◽  
Ulnar Nerve Palsy

scholarly journals Anconeus Epitrochlearis Muscle as a Cause of Ulnar Nerve Compression at the Elbow

2017 ◽  
Vol 36 (03) ◽  
pp. 190-193
Author(s):  
Luiz Cannoni ◽  
Luciano Haddad
Keyword(s):  
Surgical Treatment ◽  
Ulnar Nerve ◽  
Complete Recovery ◽  
Nerve Entrapment ◽  
Ulnar Nerve Compression ◽  
Left Hand ◽  
Ulnar Nerve Entrapment ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome ◽  
Magnetic Resonance Imaging Mri

AbstractUlnar nerve entrapment is the second most common compressive neuropathy in the upper limb, after carpal tunnel syndrome (Dellon, 1986). One of the causes that must be considered is the accessory anconeus epitrochlearis muscle, which is present in 4% to 34% of the general population (Husarik et al, 2010; Vanderpool et al, 1968; Nellans et al, 2014).We describe a patient with symptoms of compression of the left ulnar nerve at the elbow and the result of the surgical treatment.The patient presented with hypoesthesia in the fourth and fifth fingers of the left hand, and reduction of strength in the fifth finger abduction. No alterations were found in the thumb adduction.Initially, the treatment was conservative (splint, physiotherapy, analgesics); surgical treatment was indicated due to the continuity of the symptoms.The ulnar nerve was surgically released and transposed, with complete recovery after 6 months of follow-up.Ulnar nerve entrapment at the elbow by the anconeus epitrochlearis muscle is not common, but it must not be ignored (Chalmers, 1978). Ultrasonography (Jung et al, 2013; Bargalló et al, 2010), elbow magnetic resonance imaging (MRI) (Jeon, 2005), and electromyography (Byun, 2011) can help establish the proper diagnosis.

Comparative study of surgical treatment of ulnar nerve compression at the elbow

2010 ◽  
Vol 19 (4) ◽  
pp. 513-519 ◽  
Author(s):  
Grigorios I. Mitsionis ◽  
Grigorios N. Manoudis ◽  
Nikolaos K. Paschos ◽  
Anastasios V. Korompilias ◽  
Alexandros E. Beris
Keyword(s):  
Surgical Treatment ◽  
Comparative Study ◽  
Ulnar Nerve ◽  
Nerve Compression ◽  
Ulnar Nerve Compression
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