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

Instr Course Lect

Instructor, Philadelphia Hand Center, Thomas Jefferson University Hospital, Department of Orthopaedic Surgery, Department of Surgery-Division of Plastic Surgery, Philadelphia, Pennsylvania.

Published: February 2017

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 branch 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 surgeons to appreciate a patient's clinical findings and helps guide surgical decompression.

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