Fields of treatment / Neurosurgery / Guyon canal syndome
Guyon canal syndome
Guyon canal syndrome is a relatively rare peripheral ulnar neuropathy. It occurs in the upper arm and is known as compressive neuropathy. It is defined as compression of the ulnar nerve at the level of the wrist. This injury can be mostly due to repetitive strain injury to the wrist, wrist trauma, an anatomical anomaly (hypertrophic ligament, aberrant muscle). Other etiologies include ganglion cyst or a lipoma).
Symptoms of Guyon Canal Syndrome
Symptoms of Guyon canal syndrome are somewhat similar to cubital tunnel syndrome. It can be challenging to diagnose it. When a patient is suspected of Guyon canal syndrome, the only way to differentiate it from another neuropathy is an EMG test.
The symptoms usually include:
- Tingling in the ring and little fingers and in the palm of the hand
- Numbness in the ring and little fingers
- Pain that radiates up the arm as far as the elbow
- Worsened sensation, weakened grasp, weak pinch resulting in difficulty doing certain actions involving the fingers (fastening buttons, grasping knife and work)
- Muscle atrophy
- Worsened range of motion of little and ring fingers that may even lead to a claw hand
Diagnostics
To confirm the diagnosis, a nerve test called EMG known as electromyography is necessary, measuring electrical response in nerves. The patient’s presentation of symptoms is also assessed.
Treatment
Guyon’s Canal Syndrome can be managed conservatively or surgically. Conservative treatments to relieve pain may include the following options: changes to patient’s routine (avoiding activities causing pain), rehabilitation, kinesiotaping, nonsteroidal medication, steroid injections. If conservative options fail, surgical management of the syndrome is necessary. It involves surgical decompression of the nerve. This surgery can usually be done as an outpatient procedure.
The aim of the surgery is to decrease the pressure on the nerve in Guyon’s canal. It improves blood supply and removes pain. A 5cm incision is made in the wrist. The nerve is released, and pressure is taken off the nerve. The surgery can be done using a general anaesthetic or a regional anaesthetic. Care is taken that mobility is unaltered.
