Orthopedics Book

http://www.fpnotebook.com/

Ulnar Tunnel

Aka: Ulnar Tunnel, Ulnar Neuropathy, Guyon Canal Syndrome, Cyclist's Palsy, Ulnar Nerve Injury at the Wrist
  1. See Also
    1. Overuse Syndromes of the Hand and Wrist
    2. Peripheral Nerve Injury
  2. Epidemiology
    1. Much less common than Median Nerve compression
  3. Etiology: Ulnar Nerve compression
    1. Soft tissue tumors
    2. Ganglion Cyst
    3. Constricting bands or muscles
    4. Ulnar artery thrombosis
    5. Jackhammer use
    6. Compression against handlebar in bicyclists
  4. Symptoms and Signs
    1. Ulnar NerveNeuropathy
    2. Affects ulnar 1.5 fingers on palmar surface
    3. Does not affect Forearm or finger dorsum
    4. Motor Neuropathy is uncommon since the motor aspect of the nerve is deeper at the wrist
  5. Differential diagnosis
    1. Carpal Tunnel Syndrome
      1. Neuropathy is in Median Nerve distribution
    2. Cubital Tunnel
      1. Affects ulnar innervation over Forearm
      2. Affects dorsal 1.5 fingers in ulnar distribution
  6. Management
    1. See Carpal Tunnel Syndrome
    2. Avoid local Corticosteroid Injection
    3. Pad volar wrist
    4. Splint wrist in neutral position
    5. Avoid exacerbating factors
    6. Surgical intervention is rare
  7. Course
    1. Anticipate 6 month course
  8. References
    1. Elhassan (2007) J Am Acad Orthop Surg 15(11): 672-81
    2. Neal (2010) Am Fam Physician 81(2): 147-55

Navigation Tree