Guyon's canal syndrome
Moderator(s): Robert Thomas
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Guyon's canal syndrome 0 R. Thomas Guyon’s Canal Syndrome Guyon’s canal compression is similar to carpal tunnel syndrome except that Guyon’s involves the ulnar nerve as is passes into the hand. With carpal tunnel syndrome patients will experience numbness and tingling in the thumb, index, long and half of the ring finger. With Guyon’s the symptoms of numbness and tingling are in the ring and small finger. Case Study 40 year old male is seen in the clinic for numbness and tingling in the ring and small finger for the past two months. He states that he had a wrist fracture that was treated conservatively six months ago. He rides his bicycle daily and goes to the gym and lifts weights. He states that his job involves tight gripping and he operates a jack hammer. His other complaints involve hand fatigue and weakness. He denies elbow pain or injury to the elbow. Examination Physical exam reveals no atrophy to the thenar or hypothenar muscles. Patient has full function of the hand. He has a negative Froment and Jeanne’s sign. He has some mild clawing of the ring and small finger and decrease strength with abduction and adduction. The ulnar nerve is nontender at the elbow. No subluxation of the nerve with active or passive extension and flexion. Compression over Guyon’s canal in the hand increases the tingling into the ring and small finger. Two point discrimination is intact at 5mm. Summary The clinical diagnosis for this patient would be Guyon’s canal compression. The next step would be to obtain NCV/EMG studies to confirm the diagnosis. Depending on the results of the study you will proceed with conservative management such as occupational therapy and bracing or surgical management to decompress the canal.
by R. Thomas
Monday, March 25, 2019