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Surgery of the Peripheral Nerve
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ravikiran Shenoy, Gorav Datta, Max Horowitz, Mike Fox
Incising the volar carpal ligament, the palmaris brevis muscle and the hypothenar fibrous tissue will decompress the ulnar nerve within Guyon's canal. The nerve need not be completely circumferentially dissected out as this may devascularize it. Distally, the interval between the pisohamate and pisometacarpal ligaments is explored for any masses, fibrous bands or fracture fragments. The superficial branch passes superficial to the fibrous arch of the hypothenar muscles. The ulnar artery must be examined at this point to ensure that it is free of aneurysm or thrombus – it should be smooth and not tortuous.
Upper Limb
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The pisiform bone (20) can be considered as a sesamoid within the termination of the tendon of flexor carpi ulnaris (23), which anchors via the pisohamate ligament to the hook of the hamate and via the pisometacarpal ligament to the base of the fifth metacarpal bone.
The Heart (HT)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Ozdemir et al describe Guyon’s canal as a 4.0 – 4.5 cm long tunnel starting proximal to the hypothenar eminence and extending to the fibromuscular arch at the hypothenar eminence.17 The palmar carpal ligament, palmaris brevis, and fibrous tissue build the roof of the canal. The flexor digitorum profundus, transverse carpal ligament, the pisohamate and pisometacarpal ligaments form the floor. The flexor carpi ulnaris, pisiform bone, and abductor digiti minimi create the ulnar aspect of the canal. Its radial side comprises the hook of the hamate, transverse carpal ligament, and digital flexor tendons.
Acute ulnar nerve compression associated with pisiform fracture – a case report and literature review
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Min Kai Chang, Robert Tze Jin Yap
Intraoperatively, the ulnar nerve was found to be in continuity and contused over the fracture site at zone 1, proximal to the bifurcation of the ulnar nerve (Figure 3). The ulnar artery was intact and protected. The pisiform fracture was comminuted with the distal fragment attached to the pisohamate and pisometacarpal ligament. The distal and proximal fragments of the pisiform were removed, and the Guyon canal was decompressed (Figure 4(a,b)).