Mobilização do osso pisiforme no tratamento da neuropraxia do nervo ulnar no canal de Guyon: relato de caso / Pisiform bone mobilization for treating ulnar nerve neuropraxia at Guyon's canal: case report

As neuropraxias do nervo ulnar são lesões bastante freqüentes que provocam efeitos deletérios, como diminuição de força muscular e parestesias; geralmente ocorrem no nível do epicôndilo medial e do túnel ulnar (canal de Guyon). São escassos os relatos referentes a técnicas de terapia manual para compressões do nervo ulnar no canal de Guyon. Este trabalho relata o uso da técnica de mobilização do pisiforme na compressão do nervo ulnar no canal de Guyon de um homem que sofreu luxação do punho direito aos 8 anos e, aos 25, queixava-se de um deficit para adução do dedo mínimo, que atrapalhava a realização de algumas atividades de vida diária. O paciente foi submetido a uma única sessão de mobilização articular do pisiforme. Após a aplicação da técnica, o sinal positivo do teste foi eliminado, restabelecendo-se a função de adução do 5o dedo. Embora carecendo de maior fundamentação teórica, pode-se afirmar que a técnica usada, de mobilização articular do osso pisiforme, é eficaz para melhora do quadro de paresia por neuropraxia do nervo ulnar no canal de Guyon...

A common ulnar nerve neuropraxia is lesion that may result in muscle strength decrease and/or paresthesia; it usually takes place at medial epicondylelevel and the ulnar tunnel (Guyon’s canal). Studies on manual therapy techniques for ulnar nerve compression in Guyon’s canal are scarce. This paper reports the use of a technique of pisiform bone mobilization for relieving ulnar nerve compression in Guyon’s canal, in a man who had suffered a luxation of the right wrist at the age of 8 and, at 25, complained of adduction deficit of the fifth finger that interfered in his daily life activities. He was submitted to one session of pisiform mobilization; after the session, the positive test sign was eliminated, thus restoring the fifth finger function. Though lacking further grounding, it may be said that the technique used, of mobilizing the pisiform bone joint, is effective to restore normal function after ulnar nerve compression at the Guyon’s canal...

Ulnar nerve; occupational causes of compression across elbow

To determine the etiology of ulnar nerve compression across the elbow. Retrospective and descriptive. At AFIRM Rawalpindi. From Jan 2000 to Jan 2004. 267 cases of Ulnar Nerve Compression at elbow diagnosed after electro-physiological studies were selected. Most of the patients with a variety of complaints were referred to Rehabilitation Medical Department, Rawalpindi [AFIRM] for diagnostic evaluation [NCS/EMG] and management. Out of 267 patients 210 [78.65%] were males and 57 [21%] were females. The mean age was 35 yrs [Range 9-67yrs]. Most of the patients 180 [67.41%] had left sided Ulnar nerve compression at elbow where as 87 [32.59%] suffered on Right side. The most common mode of presentation were paraesthesia 234 [88%], pain 166 [44%] and weakness of intrinsic hand muscles 104 [27%]. Electro-physiological evaluation shows prevalence of occupational 121 [45%] and traumatic 51 [21%] causes. Management of Ulnar never compression must include a comprehensive rehabilitation program that should focus on postural correction and workstation modification along with pharmacological and surgical advice