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Ulnar nerve compression in Guyon's canal caused by calcinosis in scleroderma
R T Thurman1, P Jindal, T W Wolff
1Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Ky.
The Journal of Hand Surgery
|July 1, 1991
Summary
Scleroderma-related calcium deposits in Guyon's canal caused ulnar nerve paralysis. Surgical removal of these deposits rapidly relieved pain and restored hand function after nerve regeneration.
Area of Science:
- Orthopedics
- Neurology
- Rheumatology
Background:
- Scleroderma is a connective tissue disease causing hardening and tightening of the skin.
- Guyon's canal syndrome involves compression of the ulnar nerve at the wrist.
- Ulnar nerve paralysis can lead to significant hand dysfunction.
Observation:
- A 70-year-old woman with scleroderma presented with low ulnar nerve paralysis.
- Imaging revealed calcium deposits within Guyon's canal compressing the ulnar nerve.
Findings:
- Surgical excision of the calcium deposits provided rapid pain relief.
- Following nerve regeneration, the patient's characteristic claw hand deformity resolved.
- Full recovery of digital abduction and adduction was achieved.
Implications:
- Surgical decompression is an effective treatment for ulnar nerve paralysis caused by calcium deposits in Guyon's canal.
- Early intervention can prevent long-term hand deformities in scleroderma patients.
- This case highlights the importance of considering ectopic calcifications in the differential diagnosis of nerve compression syndromes.