Ulnar nerve entrapment in guyon's canal due to recurrent carpal tunnel syndrome: case report

Abstract

Guyon's canal syndrome is a compression neuropathy of the ulnar nerve entrapment at the wrist. Compression of the ulnar nerve at the wrist by a ganglion, lipomas, diseases of the ulnar artery, fractures of the hamate and trauma are common etiologcal factors. Unlike Guyon's canal syndrome, carpal tunnel syndrome (CTS) is the most common nerve entrapment of the upper extremity. Although, open (OCTR) or endoscopic carpal tunnel release (ECTR) is highly effective in relieving pain, failure with carpal tunnel release is seldom seen. In this paper, we presented a patient with ulnar nerve entrapment associated with recurrent CTS and discussed the possible pathomechanism with a review of current literature. KeywOrds: Guyon's canal, Recurrent carpal tunnel syndrome, Ulnar nerve, Median nerve ÖZGuyon kanalı sendromu ulnar, sinirin el bileğindeki basısına bağlı olarak gelişen bir tuzak nöropatisidir. Bası sebepleri arasında ganglion, lipom, ulnar arter hastalıkları, hamat kırıkları ve travma yaygın olarak bulunur. Karpal tünel sendromu ise üst ekstremitelerin en sık izlenen sinir tuzaklanmasıdır. Açık ya da endoskopik olarak yapılan karpal tünel serbestleştirilmesi ağrıyı azaltmada oldukça etkili olsa da, serbestleştirmede başarısız sonuçlar da nadir olarak izlenmektedir. Bu yazıda, rekürren karpal tünel sendromu ile birlikte gelişen bir ulnar sinir tuzaklanmasını sunduk ve olası patomekanizmayı literatür eşliğinde tartıştık.

Do Comorbid Ulnar Symptoms or Ulnar Neuropathy Affect the Prognosis of Workers With Carpal Tunnel Syndrome?

“…In clinical settings, some case reports suggest that associated median and ulnar neuropathies affect prognosis after nerve release. 38–10 However, our results are consistent with a recent study of ulnar neuropathy at the elbow; while 60.5% of subjects had persistent symptoms at follow-up, there were no differences in disability and symptom severity seen among the 5% of patients with ulnar neuropathy who had comorbid CTS. 14 …”

Peripheral nerve lipoma: Case report of an intraneural lipoma of the median nerve and literature review

“…The majority of lipomas involving the peripheral nerves were reported in the median,[ 2 3 5 12 14 15 16 17 ] radial,[ 18 19 20 21 22 ] and ulnar nerves. [ 23 24 ] There are also reports about lipomas involving the brachial plexus,[ 9 25 ] suprascapular,[ 26 ] supraclavicular,[ 27 ] posterior tibial,[ 28 29 ] and fibular nerves. [ 29 30 ] In their series of 146 nonneural nerve sheat tumors in a period of 30 years, Kim et al[ 9 ] reviewed 16 adipose tumors involving peripheral nerves.…”

Low Motor Ulnar Nerve Palsy Caused by a Traumatic Pseudoaneurysm of the Ulnar Artery

“…Computed Tomography can identify PSA on transverse source images, but the diagnosis may be helped by its ability to perform multiphase imaging with 2D and 3D reconstructions using intravenous contrast. MRI is useful as an adjunct to ultrasound or an alternative to computed tomography in patients with The medical literature reveals different causes of UTS, including repetitive trauma neuropathies [13], ulnar artery thromboses [14,15], anomalous muscle bellies or fibrous bands [4,16], fractures or dislocations of the ulnar side of the wrist [6,17], rheumatoid tenosynovitis [17], osteoarthritis of the radio-ulnar and carpal joints [13,18], lipomas [19], giant cell tumors [5], and bipartite hamate [7].…”