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. 2015 Mar;40(3):560-5.
doi: 10.1016/j.jhsa.2014.09.026. Epub 2014 Oct 29.

Guyon canal: the evolution of clinical anatomy

Brianna L Maroukis  1 , Takeshi Ogawa  1 , Shady A Rehim  1 , Kevin C Chung  2
Affiliations

Guyon canal: the evolution of clinical anatomy

Brianna L Maroukis et al. J Hand Surg Am. 2015 Mar.

Abstract

Guyon canal refers to the ulnar tunnel at the wrist named for the French surgeon Jean Casimir Félix Guyon, who described this space in 1861. After Guyon's description, clinicians have focused their interest on symptoms caused by compression of structures occupying this canal (later named ulnar tunnel syndrome or Guyon syndrome). However, disagreement and confusion persisted over the correct anatomical boundaries and terminology used to describe the ulnar tunnel. Through anatomical investigation and evolving clinical case studies, the current understanding of the anatomy of the ulnar tunnel was established. This article examines the evolution of the anatomical description of the ulnar tunnel and its relevant clinical associations and casts light on the life and contributions of Guyon.

Keywords: Guyon canal; Jean Casimir Félix Guyon; pisohamate hiatus; ulnar tunnel; ulnar tunnel syndrome.

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Figures

Figure 1
Figure 1
Anterior view of the wrist. Shows the location of the volar carpal ligament and the transverse carpal ligament in relation to the ulnar tunnel. (Reprinted with permission from Dupont C, Cloutier GE, Prevost Y, Dion MA. Ulnar-tunnel syndrome at the wrist. A report of four cases of ulnar-nerve compression at the wrist. J Bone Joint Surg Am. Jun 1965;47:757–761. Copyright © 1965 Journal of Bone and Joint Surgery American.)
Figure 2
Figure 2
A. Antero-posterior view of Guyon canal/ulnar tunnel (white arrow) and pisohamate hiatus (black arrow). TCL, transverse carpal ligament ; VCL, volar carpal ligament; FCU, flexor carpi ulnaris; PB, palmaris brevis; ODM, opponens digiti minimi; ADM, abductor digiti minimi; FDMB, flexor digiti minimi brevis; F, finger flexor tendons; N, ulnar nerve; A, ulnar artery; H, hamate. B. Axial view of pisohamate hiatus. (Uriburu et al., 1976(13)) Ulnar nerve and artery are divided into superficial and deep branches by the fibrous arch of the hypothenar muscles. C. Axial view of Guyon canal/ulnar tunnel. (Guyon, 1861(1,2)) ACL, anterior carpal ligament.
Figure 3
Figure 3
Intraoperative photograph of the right hand. Shown are the ulnar nerve (solid arrow), deep motor branch of the ulnar nerve (dotted arrow), and the pisohamate arch (*).
Figure 4
Figure 4
Magnified intraoperative photograph after pisohamate arch released. Shown are the ulnar nerve (solid arrow), the deep motor branch of the ulnar nerve (dotted arrow), and the stump of cut pisohamate arch (*).
Figure 5
Figure 5
Jean Casimir Félix Guyon (1831–1920) (BIU Health Medicine: Ref Image 02672 http://www2.biusante.parisdescartes.fr/img/?refphot=02672&mod=s)
Figure 6
Figure 6
A stamp issued by France in 1979 in honor of Guyon. (Reproduced from [Felix Guyon 1831–1920; Haas, L.F.; Volume 74; Page 698; 2003] with permission from BMJ Publishing Group Ltd.)
See this image and copyright information in PMC

References

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