Ulnar Tunnel Syndrome, Radial Tunnel Syndrome, Anterior Interosseous Nerve Syndrome, and Pronator Syndrome

Abstract

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.

Wartenberg Syndrome - an Unusual Neuropathy - Case Report and Literature Review

“…Exposure to paraclinical diagnostic elements, electromyogram and imaging is mandatory. Without these elements, the diagnosis is anamnestic and may be confused 9 . Many articles that can be consulted in the specialized literature describe causes that may be close to the sensitive branch, but few of them clearly fall into the Wartenberg syndrome.…”

Tendon of Flexor Carpi Radialis in carpal tunnel: a radiologic and cadaveric study

“…The antebrachial fascia, anteriorly, is continuous superficially as palmar carpal ligament and distally and deeply as a strong fibrous band; the flexor retinaculum (transverse carpal ligament) [1,2]. At the medial aspect of the wrist, ulnar artery and nerve pass through a tunnel between these ligaments, which is termed as the ulnar tunnel (guyon canal) [3].…”

Lateral intermuscular septum as cause of radial nerve compression: case report and review of the literature

“…Less common sites of radial nerve compression occur in the axilla in patients with an accessory subscapularis-teres-latissimus muscle, in the triangular space, within the lateral head of the triceps, and where the radial nerve penetrates the lateral intermuscular septum. Few cases have been reported of these less common sites of radial nerve compression [ 3 , 4 ], but clinicians must be familiar with these sites to ensure a timely and accurate diagnosis because a delay in treatment is often associated with a poor recovery of nerve function [ 1 , 5 ].…”