China
Africa
Explore chapters and articles related to this topic
Resource-Limited Environment Plastic Surgery
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Johann A. Jeevaratnam, Charles Anton Fries, Dimitrios Kanakopoulos, Paul J. H. Drake, Lorraine Harry
To decompress the thenar and hypothenar compartment and median and ulnar nerves (Figure 17.6).A step incision is made across the distal wrist crease, continuing as a longitudinal incision between the thenar and hypothenar eminences up to at least the proximal palmar crease (Figure 17.7).The flexor retinaculum is divided to release the carpal tunnel and median nerve, which lies immediately underneath.The motor branch of the median nerve passes radially into the thenar muscles, at the distal end of the carpal tunnel, and should be preserved.The thenar compartment is decompressed by incising the overlying fascia.Guyon’s canal, through which the ulnar nerve and artery run, is decompressed by deepening the incision in an ulnar direction, superficial to the flexor retinaculum.Continuing in an ulnar direction allows decompression of the hypothenar compartment.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Since the carpal tunnel exists as a confined space, entrapment of the median nerve may occur within it. This is commonly due to a build-up of fluid within the carpal tunnel, or because of hypertrophy of the bones/ligaments/tendons that surround, or are contained within, the carpal tunnel. Compression of the median nerve within the carpal tunnel is known as carpal tunnel syndrome. Note this is different from cubital tunnel syndrome, which refers to compression of the ulnar nerve behind the medial epicondyle at the elbow. The ulnar artery and nerve do not pass through the carpal tunnel, but instead pass superficial to the carpal tunnel in their own fibro-osseous tunnel commonly given the name Guyon’s canal. The ulnar nerve and artery are therefore unaffected in carpal tunnel syndrome.
Upper limb
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Ulnar nerve compression in Guyon’s canal can lead to tingling and numbness in the ring and little fingers with hypoth- enar wasting. There is preservation of dorsal sensation over the little and ring fingers, because although these areas are innervated by the ulnar nerve the dorsal branches do not pass through Guyon’s canal. Compression is usually due to a ganglion, ulnar artery aneurysm or a fracture of the hook of hamate.
A case of a painful coalition between pisiform and hamate
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Atsuyuki Inui, Yutaka Mifune, Hanako Nishimoto, Takahiro Niikura, Ryosuke Kuroda
Excision of the pisiform has been reported to treat pisotriquetral complaints [8]. Berkowitz et al. also demonstrated two cases of the pisiform–hamate fusion which caused ulnar neuropathy. Excision of the pisiform, combined with the decompression of the Guyon canal has been previously reported [9]. On the other hand, Zeplin et al. reported screw fixation between the pisiform and hamate to achieve complete fusion [2]. In the present case, we observed type 1 coalition and speculated that the minor movement between pisiform and hamate caused pain. Because we were unsure whether bone fusion could be achieved with screw fixation, excision of pisiform was performed. Preoperative MRI and interoperative findings revealed that the ulnar nerve ran over the hook of the hamate, which is a nonanatomic site. The surgeon must be aware that this type of coalition can cause ulnar wrist pain. Moreover, the ulnar nerve must be taken care of during surgical treatment.
Bilateral Martin-Gruber and Marinacci Anastomosis Associated with Carpal Tunnel and Guyon’s Canal Syndrome: Case Report
Published in The Neurodiagnostic Journal, 2022
María Alejandra Maya-González, David Ernesto Geney-Castro, Fabio Salinas-Durán
The present case describes the presence of a bilateral MGA that innervates both the abductor digiti minimi and the FDI muscles; concomitantly associated with a bilateral MA, CTS, and a type III Guyon’s canal syndrome, which seems to be a very unusual finding not previously described in the literature. The presence of apparent conduction blocks in the median and ulnar nerves could be confused with a pathological process, hence it is important that during electrodiagnostic medicine consultation, the practitioners are familiarized with the techniques that allow differentiating pathological processes from anatomical variants and so avoiding diagnostic errors.
Metallic foreign body in the ulnar nerve in the Guyon’s canal and Review of the Literature
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Marco Guidi, Stefano Lucchina, Bong-Sung Kim, Inga Besmens, Paolo Ivan Fiore, Nicola Altin, Alan Cortesi, Nora Huber, Maurizio Calcagni, Martin Riegger
During the exploration of the wound, it was not possible to detect the foreign body in the subcutaneous fat. After opening the Guyon's canal, the foreign body was located easily under fluoroscopy medial to the ulnar artery (Figures 1 and 2). The ulnar nerve in the Guyon’s canal had been injured by the foreign body that was detectable between the fascicles. The ulnar artery was intact. A small section of the epineurium (Figure 3) of the ulnar nerve was made and the foreign body removed. The nerve then was reconstructed under microscope with fibrin glue (Figure 4).