Hand Surgery

Loge de Guyon Syndrome - Distal Nervus Ulnaris Compression Syndrome I

Cause / development

The nerve of the ulna (nervus ulnaris) runs through a tunnel in the wrist area called "Loge de Guyon". It is located on the ulna end of the carpal tunnel (towards the body in the vicinity of the small finger ball) and is created by various tendons. Over its expanse, the nervus ulnaris is divided into its superficial and its deep branch. The former provides the small finger and the ring finger with the ability to feel ( on the small finger end). The deep branch takes care of the small hand muscles. If the tunnel is too tight, sensory problems as well as the paralysis of the small hand muscles may occur. This compression syndrome is frequently found in cyclists. The handlebar of the bicycle causes the Loge de Guyon to be compressed, which results in pressure damage to the nervus ulnaris.

Symptoms

As described above, the pressure damage may result in the paralysis or the loss of strength in the hand as well as sensory problems in small and ring finger (on the small finger end). As the disease progresses, the small hand muscles between the middle hand bones are reduced in size – especially between thumb and index finger.

Prior to treatment

A neurologist can determine if the nervus ulnaris in the hand area is compressed by measuring the "nerve streams" (= ENG / EMG). It is imperative that this measurement is taken prior to the surgery.

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