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Guyon Canal

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Introduction

Guyon Canal

Guyon’s canal also called ulnar tunnel or ulnar

canal, is an anatomical fibro-osseous canal located
on the medial side of the hand. It extends between
the proximal boarder of the pisiform bone and
distally at the hook of the hamate. The ulnar nerve
and ulnar artery pass through the Guyon canal as
they pass from distal forearm to the hand.[1][2]

Description

The Guyon canal houses the ulnar nerve and its

branches, ulnar artery and venous and lymphatic
vessels. As the ulnar nerve exits the Guyon’s canal
it is divided into deep (motor) branch of the ulnar
nerve and superficial (sensory) branch of the ulnar
nerve.[1][3]

Borders

Roof: palmar carpal ligament, palmaris

brevis and hypothenar connective tissue.
Floor: transverse carpal ligament, pisohamete
ligament, pismetacarpal ligament, flexor
digitorum profundus tendons and opponens
digiti minimi.
Medial wall: pisiform, abductor digiti
minimi and flexor carpi ulnaris tendon.
Lateral wall: hook of hamete, transverse
carpal ligament and the flexor tendons.[4]

Clinical Relevance

Guyon canal syndrome is the second reason for

compression syndromes at the wrist after carpal
tunnel syndrome. Compression of the ulnar nerve
at the Guyon’s canal leads to specific sensory and
motor symptoms according to the location of the
compression.[1]

Hypothenar hand syndrome is caused by repeated

trauma to the hypothenar region, resulting in
injury to the ulnar artery in Guyon space.[5]

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Guyon Canal Syndrome - Physiopedia

Introduction Guyon's Canal Guyon Canal syndrome
which is also known as Ulnar Tunnel Syndrome is a
relatively rare peripheral ulnar neuropathy. Guyon
canal syndrome is also known as ulnar tunnel
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much like themanagement 'carpel tunnel orsyndrome'
surgical decompression.but in this case
Conservative
the ulnar nerve
Contribute treatment
is involved. is recommended
Cyclist are prone for mild to this and
moderate
kind compression. symptoms with duration
Arterial injury toofthe lessulnar thanartery 3
months.
can also Surgical
Shop affect thetreatment HT eminence is recommended
due to insufficient for
moderate blood
collateral to veryflow, severe symptoms
leading with duration
to a condition calledof at
least
Contact 2 months.
'hypothenar hammer Physical Therapy Management[edit
syndrome'. Depending on flow|
edit source] Conservative
compromise, necrosis of the treatment
HT eminence consists canofalso patient
instructions
occur. Individuals and splinting.that workUltrasound with tools (US) needing and tight nerve
Content
glide exercise
gripping can be added
and repetitive pounding depending can sufferon patient’s with such
situation
injury as the
Articles andaction personal preferences.[5]
of gripping and pounding Ulnar nerve causes
glide
recoilexercise
impact on based the on the Butler
vascular blood concept
supplyfor in thethe ulnar
nerve
hypothenar
Categories is as follows:eminence[2] WristProximal extension, forearm of the
compromise
pronation
nerve and/or elbow theflexion,
artery will glenohumeral
show symptomatic lateral rotation,
glenohumeral
changes in thedepression,
Presentations hypothenarshoulder eminence abduction.[7]
in both the The
patient
resting is and instructed
active presentation to avoid activities of the hand. that cause A loss or
repetitive
decrease ofstress
Research sensation at Guyon’s and the canalfeeling suchofas pins weight and
bearing (paraesthesia)
needles or cycling or modification in the HT eminence of the bicycle can also
Resources
handlebars.
indicate a C8Also, spinal to root
avoidlesion staticon postures
the ipsilateral or repetitive side
movements
due to the dermatomal that places mechanical distribution overload for C8[2].such . [7]as
Projects
prolonged
Assessment[edit wrist extension.| edit source] TheWhen patient ulnaris instructed
nerve to
wear resting occurs
compromise hand splint at thetoGuyon's place the wristit in
canal neutral
causes
position.
weaknessThe
Legal withsplint abduction shouldand be wornadduction for 1-12 of the weeks fingers,
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the PIP, aggravating
and
activities.
Disclaimer
adduction and Thisflexion management at the MCP is from of the thethumb.European
handguide study
Hypothenar muscles treatment
are alsoguidlines. not spared [5]due Surgical
to their
Decompression[edit
Terms
innervation by the ulnar | editnerve[3].
source] The aim ofTunnel
In Carpel the
surgery
Syndrome is to (CTS),decrease where the pressure
median nerve on the ulnar canal
compromise
Privacy
in Guyon's
occurs, thenar canal by removing
muscles can show thewasting
roof of the as they Guyon are
canal or removing
innervated by the median the structures nerve. If compressing
noted, otherthe CTS
Cookies
nerve.
tests like Duringthe Phalen's the early sign post-operative
and the Tinel's period test (up should to
10-15 days afterPhalen's
be conducted. surgery), sign theispatientpositive is when
advised to
numbness
elevate
and tingling his hand, occurs provide
whenappropriate
the patient rest raises of thethe hands hand,
do gradual
out in fronthand and
of Physiopedia
him or wrist
herself, movements
flexes thewithout
available wrist
in: and
resistance
places the dorsal as tolerated wristsand to avoid
together, applying
while flexed, heavy
for
loads
about on 60French
the
seconds.hand or doing
Tinel's German
testforceful
is positive activities.Italian
whenThe post-
surgical
numbness instructions
andSpanish tingling include
is experiencedscar care,when
Ukrainian edema the control,
hand and wrist
examiner taps the mobilization
medial aspect and of ergonomics
the wrist, advice at the to
avoid
median putting
nerve.mechanical For a complete loadwrist on the and nerve.
handSplinting
after surgery is
examination, see not Wristroutinely and Hand indicated, Examination it is indicated [8] [9]
only for patients| edit
Treatment[edit withsource] severe pain In most after acutesurgery case and
patients who
injuries, rest, are icing, likelypaintorelief, put mechanical
support and load on the
activity
canal.
modificationPost-surgical helps with exercises recovery. is indicated
Where there for patients is
with
residual reducedweakness handof mobility
the muscles in a case or mild of hand to moderateedema or
the patient fearing
neurological compromise, using the hand, to promote
physiotherapy can aid nervein
glide and to
acquiring strengthen
normal Hand the Function muscles [10] of [11]
the In hand.[5]
case of
Differentialmalfunction Diagnosis[edit | edit source] Alcohol-
©functional of the hand needing surgery,
Physiopedia 2023 | Physiopedia is a registered
related
the knowledgeneuropathy of the Amyotrophic
anatomy of the lateralthenar sclerosis and
charity in the UK, no. 1173185
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hypothenar plexus eminence abnormalities becomesCervical vital fordisc a safe diseaseand
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