Hand Conditions

Nerve / Tendon:
Carpal Tunnel Syndrome
Focal Dystonia Syndrome
Guyon's Canal Syndrome
Hypothenar Hammer Syndrome
Trigger Finger/Tenosynovitis

Bone / Joint:
Arthritis of the Hand
Arthritis of the Thumb (Basilar Joint)
Dupuytren's Disease
Navicular Avascular Necrosis (and Kienböck's disease)

Guyon's Canal Syndrome

Similar to the type of compression placed on the median nerve in Carpal Tunnel Syndrome cases, Guyon's Canal Syndrome is a less common nerve compression affecting the ulnar nerve as it passes through a tunnel in the wrist called Guyon's Canal.

Running from the neck and down the arm to the hand and fingers, the ulnar nerve crosses the wrist with the median and radial nerves. The ulnar nerve and ulnar artery run through the Guyon's canal - a tunnel formed by two bones, the pisiform and hamate and connecting ligaments. Once it passes through the canal, it branches out to supply feeling to the little finger and half of the ring finger. Other branches of this nerve supply the small muscles in the palm, as well as the muscle that pulls the thumb toward the palm. A number of activities or other conditions may cause the ulnar nerve to become compressed, resulting in this condition.

Symptoms generally include numbness in the little finger and half of the ring finger. Progression can cause the gradual weakening of the muscles controlled by the ulnar nerve, which eventually makes it difficult to spread out the fingers and pinch the thumb.

Risk Factors
Generally adult men and women involved in strenuous tasks involving the wrist, such as; heavy gripping or twisting, constant pressure placed on the palm such as in cycling and weightlifting, and uncommon or unnatural activities placing great pressure on the wrist such as using a jackhammer or crutches, or pushing a stroller, are at greatest risk for Guyon's Canal Syndrome.

A traumatic injury to the wrist may also cause swelling and place pressure on the ulnar nerve within the canal. And arthritis in the wrist bones and joint may irritate and compress the nerve as well.

Diagnosis and Treatment
Upon a thorough physical examination, patient history review and possible nerve conduction velocity (NCV) test, which measures how fast nerve impulses travel along the nerve, the type of compression and its exact location are determined.

Occasionally the NCV test is performed in conjunction with an electromyogram (EMG). The EMG can determine if the forearm muscles controlled by the ulnar nerve are functioning properly. If the symptoms were the result of a traumatic wrist injury, an X-ray may be taken to check for a fracture or dislocation.

Conservative treatment is generally all that is indicated for Guyon's Canal Syndrome - NSAIDs and reduction of the activity causing the pressure, or change of hand position. Physical therapy may help to facilitate this process. A wrist brace may also be used to alleviate the symptoms by keeping the wrist in "resting position" and decreasing the pressure placed on the nerve.

A surgical procedure to release the ligament above the canal and reduce the pressure to the ulnar nerve is performed, if conservative treatment is unsuccessful.