In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms. Spontaneous neuropathy of the anterior interosseous nerve of the median nerve can be observed without external compression. Electrodiagnostic and imaging studies may aid surgeons in the diagnosis of these syndromes; however, a thorough physical examination is paramount to localize compressed segments of these nerves. An understanding of the anatomy of each of these nerve areas allows practitioners to appreciate a patient's clinical findings and helps guide surgical decompression.
Despite the dramatic initial reduction in contracture, recurrence developed in a high proportion of patients over the study period. While initially effective, CCH may not provide durable contracture reduction. However, CCH remains a viable nonsurgical treatment for Dupuytren's disease.
Forearm instability is a complex problem resulting from traumatic disruption of the forearm stabilizers: the radial head, the interosseous membrane, and the triangular fibrocartilage complex. Dissociation of the forearm unit is often underrecognized and therefore inadequately treated, leading to poor patient outcomes. The goals of this article are to impart an understanding of the forearm anatomy and the current concepts in the diagnosis and treatment options for this complicated problem.
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