J Korean Soc Surg Hand.  2015 Sep;20(3):148-152. 10.12790/jkssh.2015.20.3.148.

Identification of Double Compression Lesion of Ulnar Nerve after Cubital Tunnel Release

• Kim JY
• Kwak HI
• Yoo JH
• Kim JH
• Sohn DW
• Cho JH

• KMID: 2068822
• DOI: http://doi.org/10.12790/jkssh.2015.20.3.148

Abstract

The double compression syndrome of the ulnar nerve is a rare condition. Herin, we experienced double compression of ulnar nerve at cubital tunnel and Guyon's canal by re-evaluation after surgical decompression of cubital tunnel. We might suspect the double compression lesion in cases of worsening of symptom or nerve conduction velocity findings in a relative short duration of symptom as in our case. Meticulous physical examination might be needed to detect the Guyon's canal syndrome as a comorbidity in the treatment of cubital tunnel syndrome and re-evaluation for dual compression might be recommended if the resolution of symptom was not achieved after surgical decompression of single nerve lesion.

Keyword

Cubital tunnel syndrome; Guyon's canal syndrome; Double crushing syndrome; Double compression syndrome; Surgical decompression

MeSH Terms

Comorbidity
Cubital Tunnel Syndrome
Decompression, Surgical
Neural Conduction
Physical Examination
Ulnar Nerve*

Figure

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  Fig. 1. Surgical decompression of cubital tunnel and subcutaneous ulnar nerve anterior transposition were performed. Focal mild swelling of the ulnar nerve was observed (white arrow).

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  Fig. 2. Magnetic resonance imaging of Guyon’s canal. A dumbbell-shaped ganglion at the pisotriquetral joint volarly abutting the ulnar nerve at Guyon’s canal was observed. (A) T2 fat suppression coronal image. (B) T2 fat suppression axial image.

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  Fig. 3. Guyon’s canal decompression with excision of the ganglion and carpal tunnel release. (A) Ganglion was observed on the pisotriquetral ligament. (B) After excision of the ganglion, the capsule was opened. (C) Carpal tunnel release was also performed with Guyon’s canal release.

Reference

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