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e.preventDefault(); } }); } } }); </script> <div class="bodycopy"> <hr size="3" /> <p><strong>- Discussion:<br /> -</strong> Guyon (French Urologist) described this space in 1861;<br /> - Guyon's canal is approximately 4 cm long beginning at the proximal extent of聽transverse carpal ligament and ends at the aponeurotic arch of hypothenar muscles;<br /> - depression between <a href="/joints/wrist/pisiform/" data-wpel-link="internal">pisiform</a> & hook of <a href="/joints/wrist/hamate/" data-wpel-link="internal">hamate</a> is converted into fibrosseous tunnel, the tunnel of Guyon, by pisohamate ligament;<br /> - roof is formed by volar carpal ligament and pisohamate ligament;<br /> - the ulnar nerve bifurcates within the canal into superficial and deep branches;<br /> - deep branch of the ulnar nerve (more radial) and superficial branch more ulnar<br /> - tunnel of Guyon is clinically significant because it contains <a href="/nerves/ulnar-nerve/" data-wpel-link="internal">ulnar nerve</a> and <a href="/nerves/ulnar-artery/" data-wpel-link="internal">artery</a> & is site for compression injury;<br /> - ulnar artery is immediately adjacent and radial to the ulnar nerve;<br /> - consider anomalous muscles, ganglia, hamate fractures ect.<br /> <strong>- zone 1 compression</strong>:<br /> - extends from the proximal edge of the palmar carpal ligament to the bifurcation of the ulnar nerve<br /> - compresses聽sensory and motor aspects of the ulnar nerve as well as the motor innervation of the hypothenar muscles<br /> - <strong>zone 2 compression</strong>:<br /> - extends from the bifurcation of the ulnar nerve just distal to the fibrous arch of the hypothenar muscles<br /> - the deep motor branch of the ulnar nerve is susceptible to compression;<br /> - <strong>zone 3 compression</strong>:<br /> - contains the superficial sensory branch of the ulnar nerve;</p> <p><strong>- Technique of Decompression:</strong><br /> - the pisiform and the hamate are marked;<br /> - a curvilinear incision is made between the pisiform and the hamate, and is extended proximally across the wrist crease and is then continued<br /> along the medial border of the <a href="/muscles-tendons/flexor-carpi-ulnaris/" data-wpel-link="internal">FCU</a>;<br /> - the ulnar nerve and artery are identified beneath the FCU;<br /> - the deep dissection proceeds distally over the ulnar tunnel;<br /> - incise through the palmaris brevis and palmar carpal ligament;<br /> - examine the floor of Guyon's canal, and attempt to identify any anomalous muscles or ganglion cysts</p> <hr size="3" /> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/2754196" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">Diagnosis of ganglion in Guyon's canal by magnetic resonance imaging<span class="wpel-icon wpel-image wpel-icon-6"></span></a>.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/1864038" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">The failed ulnar nerve transposition. Etiology and treatment<span class="wpel-icon wpel-image wpel-icon-6"></span></a>.</p> <p><a class="title wpel-icon-right" href="http://www.ncbi.nlm.nih.gov/pubmed/8228065" data-wpel-link="external" target="_blank" rel="external noopener noreferrer">Ulnar artery palmar to palmaris brevis: cadaveric study and three case reports.<span class="wpel-icon wpel-image wpel-icon-6"></span></a></p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/8891986" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">Guyon's canal revisited: an anatomic study of the carpal ulnar neurovascular space<span class="wpel-icon wpel-image wpel-icon-6"></span></a>.</p> <p>General Orthopaedics: <a href="http://www.ncbi.nlm.nih.gov/pubmed/3995823" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">The Anatomy of the Distal Ulnar Tunnel<span class="wpel-icon wpel-image wpel-icon-6"></span></a>.</p> <p><a href="http://www.ncbi.nlm.nih.gov/pubmed/12877855" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">Causes of ulnar tunnel syndrome:聽a retrospective study of 31 subjects<span class="wpel-icon wpel-image wpel-icon-6"></span></a>.</p> <p><a href="http://www.sciencedirect.com/science/article/pii/S0363502314013434" data-wpel-link="external" target="_blank" rel="external noopener noreferrer" class="wpel-icon-right">Guyon Canal: The Evolution of Clinical Anatomy <span class="wpel-icon wpel-image wpel-icon-6"></span></a></p> </div> <p> </p> <hr /> <p>Original Text by Clifford R. Wheeless, III, MD.</p> <p>Last updated by Clifford R. 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