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Subperiosteal Ulnar Nerve Entrapment at the Wrist
Cyrus Steppe1, Houshang Seradge1, Winfred Parker1
1Seradge Medical, Oklahoma City, OK.
Journal of Hand Surgery Global Online
|April 13, 2022
Summary
Ulnar nerve entrapment at the wrist, often caused by ganglions or trauma, can lead to hand dysfunction. A rare anatomical variation caused a sculptor's deep motor ulnar nerve to compress within the carpal tunnel.
Area of Science:
- Hand surgery
- Anatomy
- Neurology
Background:
- Ulnar nerve entrapment at the wrist presents with significant sensory and motor deficits.
- Common causes include ganglions, lipomas, and trauma.
- Accurate diagnosis and surgical treatment are crucial for functional recovery.
Observation:
- A professional sculptor experienced intrinsic hand pain and weakness due to ulnar nerve compression.
- The deep motor branch of the ulnar nerve followed an unusual subperiosteal course.
- The nerve was compressed as it passed radially to the hamate hook and into the carpal tunnel floor via the transverse carpal ligament.
Findings:
- A previously unreported anatomical variation of the deep motor branch of the ulnar nerve was identified.
- This anomaly caused ulnar nerve entrapment within the carpal tunnel.
- Surgical intervention successfully treated the patient's symptoms.
Implications:
- Recognition of this anatomical variation is critical for surgeons performing procedures in the Guyon canal and carpal tunnel.
- Avoiding ulnar nerve injury during hand and wrist surgery is paramount.
- Understanding rare anatomical anomalies improves surgical outcomes and patient safety.
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