ABSTRACT
INTRODUCTION: Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion compressing the nerves. MATERIALS AND METHODS: We present two cases of compression of deep branch of ulnar nerve by a ganglion in the Guyon's canal. Two male patients presented with history of progressive weakness and paraesthesia in the medial 1(1/2) digits of the non-dominant hand. Interestingly, both the patients noticed sudden onset and rapid progress of the symptoms and signs. Clinical examination revealed typical symptoms of ulnar nerve (deep branch) palsy. Nerve conduction studies showed severe denervation of the deep branch of the ulnar nerves in both the patients and ultrasound confirmed the diagnosis. Surgical decompression led to complete recovery. RESULTS AND DISCUSSION: Whilst compression by a ganglion in the Guyon's canal is rare but well recognized, a feature of both of our cases was the rapid progression and severe nature of the compressive symptoms and signs. This is in contrast to the more typical features of compressive neuropathy and should alert the clinician to the possible underlying cause of compression. Early decompression has the potential to promote a complete recovery.
Subject(s)
Decompression, Surgical/methods , Ganglion Cysts/complications , Ulnar Nerve Compression Syndromes/etiology , Aged , Electromyography , Follow-Up Studies , Ganglion Cysts/diagnostic imaging , Ganglion Cysts/surgery , Hand , Humans , Male , Middle Aged , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Neural Conduction , Recovery of Function , Risk Assessment , Treatment Outcome , Ulnar Nerve Compression Syndromes/diagnostic imaging , Ulnar Nerve Compression Syndromes/surgery , UltrasonographySubject(s)
Arthroplasty, Replacement, Hip , Hip Dislocation/diagnostic imaging , Aged , Female , Humans , Prosthesis Failure , Radiography , ReoperationABSTRACT
The present anatomical and clinical literature is not detailed enough for a clear understanding of the three-dimensional anatomy of the trapezium. It lacks descriptions of identifiable landmarks needed for the interpretation of two-dimensional radiographs. Fifty dry cadaver trapezia were assessed and an extended surface anatomy described. New consistent landmarks were described and the tubercle of the trapezium was redefined. The incidence of the salient osteological features in Caucasian trapezia was recorded.
