Guyons canal release surgical technique
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The ulnar nerve and artery pass through Guyon’s canal to the hand. The canal lis superficially on the ulnar palmar side of the wrist and is bordered ulnarly by the hypothenar eminence. The ulnar nerve is vulnerable to trauma at the wrist level. Compression of the ulnar nerve at this site is rare and can be associated with tumours or ganglion swellings arising from the piso-triquetral articulation. A well-developed palmaris brevis may contribute to compression. thickening of the fascia at the distal forwarm can be associated with distal ulnar neuropathy as the nerve crosses the wrist crease to the hand through the start of Guyon’s canal. The motor branch passes deeply into the hand and courses around the hook of the hamate where it is vulnerable to injury. Symptoms of ulnar nerve compression at this site may be both sensory and motor depending on the site of compression.
Functionally there are 3 zones to Guyon’s canal. Zone 1 includes the main motor and sensory ulnar nerve proximal to bifurcation; zone 2 the deep ulnar nerve exits to pass around the hook of the hamate; zone 3 the ulnar nerve superficial branch is at risk of compression superficially in the palm.
Author: Dominic Power FRCS Orth, Consultant Hand and Peripheral Nerve Surgeon
Institution: Peripheral Nerve Injury Service, Queen Elizabeth Hospital, Birmingham, UK
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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