Causes of ulnar nerve compression in Guyon's canal are various, but thrombosis of the ulnar artery due to a single trauma is rarely reported. We report a case of ulnar nerve compression caused by traumatic thrombosis of the ulnar artery in Guyon's canal. Surgical excision of the ulnar artery thrombus and end to end anastomosis resulted in complete relief of the patient's symptoms.
Thrombosis* ; Ulnar Artery* ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes

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 is a common etiological factor. We report on a rare case of ulnar neuropathy caused by a schwannoma at the level of Guyon's canal.
Ganglion Cysts ; Lipoma ; Neurilemmoma* ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Ulnar Neuropathies* ; Wrist

The Gantzer's muscle (GM) is an additional muscle in the forearm as the accessory head of the flexor pollicis longus (FPL) and accessory head of the flexor digitorum profundus (FDP). We reported a rare case of double GM formed by four muscle bellies. From the dorsal part of flexor digitorum superficialis, small four bellies formed two muscles merging to FDP and FPL, as GMs. These accessory heads of FDP and FPL crossed the ulnar artery and the median nerve, respectively. These additional muscles in the forearm flexor compartment are rare and its clinical and embryological significances should be considered.
Forearm ; Head ; Median Nerve ; Muscles* ; Ulnar Artery

There are many methods in reconstruction for skin defect in hand and forearm. Among them, reverse ulnar artery forearm flap has several advantages which are versatile, safe and convenient flap. We report 6 cases of our experiences.
Forearm Injuries ; Forearm ; Hand ; Skin ; Ulnar Artery

Compression ulnar neuropathy was predicted by Guyon in 1961,following his anatomical studies of the ulnar tunnel. Nearly a half century later Ramsey Hunt first reported isolated ulnar motor paralysis in the hand, due to chronic occupational trauma. Many authors has tried to describe the etiology of the ulnar nerve compression syndrome at or around the wrist. That is most frequently caused by ganglion, occupational neuritis, thrombosis of the ulnar artery, thickening of volar ligament or different kinds of trauma (e.g. fractures of the carpal bones). Now we experienced a case of the ulnar nerve compression syndrome at distal forearm by an anomalous branch of the ulnar nerve by piercing the distal tendon of the flexor carpi ulnaris.
Forearm ; Ganglion Cysts ; Hand ; Ligaments ; Neuritis ; Paralysis ; Tendons ; Thrombosis ; Ulnar Artery ; Ulnar Nerve Compression Syndromes ; Ulnar Nerve ; Ulnar Neuropathies ; Wrist

Compression of the ulnar nerve in Guyon's canal can result from repeated blunt trauma, fracture of the hamate's hook, and arterial thrombosis or aneurysm. In addition, conditions such as ganglia, rheumatoid arthritis and ulnar artery disease can rapidly compress the ulnar nerve in Guyon's canal. A ganglion cyst can acutely protrude or grow, which also might compress the ulnar nerve. So, clinicians should consider a ganglion cyst in Guyon's canal as a possible underlying cause of ulnar nerve compression in patients with a sudden decrease in hand strength. We believe that early decompression with removal of the ganglion is very important to promote complete recovery.
Aneurysm ; Arthritis, Rheumatoid ; Decompression ; Ganglia ; Ganglion Cysts ; Hand Strength ; Humans ; Thrombosis ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes

PURPOSE: Compression of the ulnar nerve in the ulnar tunnel is a relatively uncommon condition. Many authors have described several etiologies of ulnar nerve compression. We experienced two cases of ulnar nerve compression in the ulnar tunnel due to an anomalous pulsatile S-shaped ulnar artery. METHODS: Case 1: A 51-year-old man was referred with numbness and paroxysmal tingling sensation along the volar side of the ring and little fingers of his right hand for 6 months. When exploration, the ulnar artery was pulsatile S-shaped and was impinging on the ulnar nerve. To decompress the ulnar nerve, the tortuous ulnar artery was mobilized and translocated radially onto the adjacent fibrous tissue. Case 2: A 41-year-old man was referred with tingling sensation on the 4th, 5th finger of the right hand for 4 months. Sensory nerve conduction velocities of the ulnar nerve was delayed. Preoperative 3D angio CT scan showed an anomalous S-shaped ulnar artery. Same operation was done. RESULTS: The postoperative course was uneventful. After decompression, paroxysmal tingling sensation decreased to less than 1 minute per episode, occurring 1 or 2 times a day. After 4 months, they had no more episodes of numbness and tingling sensation. Examination demonstrated good sensation to pinprick and touch on the ulnar aspect of the hand. CONCLUSION: We report two cases of ulnar nerve compressive neuropathy that was caused by an anomalous pulsatile S-shaped ulnar artery in the ulnar tunnel. Although this is an unusual cause of ulnar nerve compression, the symptoms will not spontaneously resolve. The prompt relief of compressive neuropathic symptoms following the translocation of the impinging ulnar artery from the affected ulnar nerve onto adjacent tissue proved that the ulnar nerve compression is due to the anomalous vessel.
Adult ; Decompression ; Fingers ; Hand ; Humans ; Hypesthesia ; Middle Aged ; Neural Conduction ; Sensation ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes

OBJECTIVE: Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy in the upper extremities. For the surgical treatment of CTS, endoscopic carpal tunnel release(ECTR) has been developed as a minimally invasive method, alternative to the open procedure over the past decade. The authors present clinical experience and surgical outcome of ECTR. METHODS: One hundred cases(34 right, 30 left and 19 bilateral hands) in 81 consecutive patients(mean age: 51.8 years, range: 33-77 years) with electrodiagnostically-proven CTS underwent a single-portal ECTR from January 2001 to December 2002. Preoperative clinical findings and results of electrodiagnostic studies were compared with surgical outcome respectively after 3-month-follow-up period. RESULTS: Among 100 cases 94(94%) were satisfied with complete or significant relief of symptoms and 6(6%) were dissatisfied with partial or no relief of symptoms. Major complications in 2 cases(one with ulnar nerve injury and the other one with ulnar artery laceration), developed in early experience of ECTR and recurrence in 1 case occured. Severity of electrodiagnostic abnormalities were correlated with surgical outcome but there's no statistical significance between them. Severity of clinical findings, age at onset and symptom duration were not correlated with surgical outcome respectively. CONCLUSION: ECTR is effective in relieving symptoms of CTS with a low complication rate after the learning curve period. Thus, ECTR can be the first procedure, alternative to the open surgery as an efficient, minimally invasive surgical technique for CTS.
Carpal Tunnel Syndrome ; Learning Curve ; Recurrence ; Surgical Procedures, Minimally Invasive ; Ulnar Artery ; Ulnar Nerve ; Upper Extremity

We observed a case of superficial brachial artery in the left arm of a Korean male cadaver. It was compared with the previously reported ones, and its characteristics were summarized as follows. 1. The superficial brachial artery, which arose from the axillary artery at the superior border of the teres major muscle, passed in front of the medial root of the median nerve and subsequently became to lie on the medial side of the median nerve. This artery crossed the median nerve anteriorly in the middle of the upper arm, then lay lateral to the median nerve in the lower part of the upper arm to the cubital fossa. 2. After giving off the deep brachial artery, several muscular branches and inferior ulnar collateral artery, the superficial brachial artery terminated in the cubital fossa by dividing into its two terminal branches, the radial and ulnar arteries. The superior ulnar collateral artery arose from the deep brachial artery, and the common interosseous artery from the ulnar artery. The course and distribution of the ulnar and radial arteries were normal. 3. It has been reported that a deeper artery, which takes the normal course of the brachial artery and continues as the common interosseous artery, usually coexists with the superficial brachial artery, even if the superficial brachial artery gives off both radial and ulnar arteries in the cubital fossa. But in our case, there was no deeper artery which passes deep to the median nerve. 4. It was presumed that this type of variation is produced by an unusual development of the superficial brachial artery that has been formed during early development as the main artery at the cost of complete degeneration of the normal brachial artery.
Arm ; Arteries ; Axillary Artery ; Brachial Artery* ; Cadaver ; Humans ; Male ; Median Nerve ; Radial Artery ; Ulnar Artery

Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve compression at Guyon's canal by an arteriovenous malformation (AVM) and the patient's symptom was improved after surgical resection. We can not easily predict vascular lesion as a cause of ulnar nerve compression at Guyon's canal. However, if there is not obvious etiology, we should consider vascular lesion as another possible etiology.
Aneurysm ; Arteriovenous Malformations ; Arthritis ; Carpal Bones ; Ganglion Cysts ; Hemangioma ; Lipoma ; Muscles ; Occupations ; Tendons ; Thrombosis ; Ulnar Artery ; Ulnar Nerve ; Ulnar Nerve Compression Syndromes ; Wrist