Anatomy ulnar nerve
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This document discusses Cubital Tunnel Syndrome and Ulnar Tunnel Syndrome. Cubital Tunnel Syndrome involves compression of the ulnar nerve at the elbow, and can cause sensory changes and weakness in the hand. It is often treated initially with splinting and anti-inflammatories, and may require surgical decompression or transposition of the nerve. Ulnar Tunnel Syndrome (Guyon's canal) involves compression in the wrist and can cause numbness and weakness, sometimes from conditions like ganglions or fractures; its treatment may involve surgical release of the canal.
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Anatomy ulnar-nerve
This document discusses Cubital Tunnel Syndrome and Ulnar Tunnel Syndrome. Cubital Tunnel Syndrome involves compression of the ulnar nerve at the elbow, and can cause sensory changes and weakness in the hand. It is often treated initially with splinting and anti-inflammatories, and may require surgical decompression or transposition of the nerve. Ulnar Tunnel Syndrome (Guyon's canal) involves compression in the wrist and can cause numbness and weakness, sometimes from conditions like ganglions or fractures; its treatment may involve surgical release of the canal.
Tarsal tunnel syndrome complete review
Tarsal tunnel syndrome is caused by entrapment of the posterior tibial nerve as it passes through the tarsal tunnel behind the ankle. It results in pain, tingling, and numbness in the sole of the foot. Diagnosis is made through physical exam maneuvers like Tinel's test and imaging like MRI or electrodiagnostic testing. Conservative treatment includes splinting, anti-inflammatories, and steroid injections, while surgery to decompress the nerve through tarsal tunnel release is considered if conservative measures fail. Differential diagnoses include other causes of foot pain like Achilles tendinitis, plantar fasciitis, or lumbar nerve impingement.
Tarsal tunnel syndrome
Tarsal tunnel syndrome is a compression neuropathy of the posterior tibial nerve as it passes through the tarsal tunnel. It commonly affects middle-aged females and causes pain, burning, and numbness on the inside of the ankle and bottom of the foot. Diagnosis involves clinical tests like Tinel's sign and imaging like MRI. Treatment begins conservatively with rest, medications, splinting and nerve glides, while surgery to decompress the nerve may be needed in some cases.
Barton’s fracture Power Point
A 68-year-old female slipped in the shower, falling onto her outstretched hand and injuring her left wrist. She was found to have obvious swelling and deformity of the right wrist with limited range of motion. The diagnosis was a distal radius fracture with dislocation of the radiocarpal joint. Treatment would involve pain control, closed reduction of the fracture under sedation, and consultation with orthopedics as non-operative treatment often fails for this type of injury.
Assignment on trauma complications
A diabetic man with a history of tibia and fibula fracture treated with interlocking nail fixation 3 months ago presented with redness, swelling and foul-smelling discharge from his left leg. X-rays showed no healing of the fracture site. He was diagnosed with chronic osteomyelitis based on clinical findings and history. Management involved investigating with blood tests and imaging, surgically debriding dead tissue, administering IV antibiotics for 2-3 weeks followed by oral antibiotics for 6-8 weeks, optimizing blood sugar control, and considering implant removal or bone grafting.
Brachial plexus examination
This document outlines the steps for examining a patient's brachial plexus, including assessing muscle wasting, scarring, range of motion, sensory function, motor function, tone, myotomes, and dermatomes. Key parts of the exam involve looking for signs of atrophy, feeling for tenderness, moving each joint to test range of motion, and testing sensory and motor function through nerves like the median, ulnar, and radial. The exam is used to determine if the brachial plexus injury is pre-ganglionic or post-ganglionic and plan further investigations and treatments.
Colles’ fracture Power Point
A 52-year-old female presented to the emergency department after falling forward on an outstretched hand. She had obvious deformity to her right wrist but no lacerations. Examination revealed a distal radius fracture with dorsal displacement of the distal fragment, known as a "dinner fork deformity". Prompt orthopedic consultation was recommended for reduction if the radius could not be reduced or if there was over 1mm of intra-articular step-off, less than 15 degrees of radial inclination, volar tilt less than neutral, or over 2mm of shortening compared to the left wrist. A sugar-tong splint was applied if indicated and the patient was referred for follow-up.
ulnar Entrapment Neuropathy and double crush syndrome
Nerve entrapment occurs when a nerve becomes compressed as it travels through tight spaces in the body. The ulnar nerve is commonly entrapped at the elbow, where it passes through the cubital tunnel, or at the wrist in Guyon's canal. Symptoms include numbness, tingling, and weakness. Treatment involves modifying activities that cause compression, splinting, and sometimes surgery to decompress the nerve. The double crush syndrome can occur when a nerve is compressed at multiple sites, worsening symptoms.
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Anatomy ulnar-nerve
This document discusses Cubital Tunnel Syndrome and Ulnar Tunnel Syndrome. Cubital Tunnel Syndrome involves compression of the ulnar nerve at the elbow, and can cause sensory changes and weakness in the hand. It is often treated initially with splinting and anti-inflammatories, and may require surgical decompression or transposition of the nerve. Ulnar Tunnel Syndrome (Guyon's canal) involves compression in the wrist and can cause numbness and weakness, sometimes from conditions like ganglions or fractures; its treatment may involve surgical release of the canal.
Tarsal tunnel syndrome complete review
Tarsal tunnel syndrome is caused by entrapment of the posterior tibial nerve as it passes through the tarsal tunnel behind the ankle. It results in pain, tingling, and numbness in the sole of the foot. Diagnosis is made through physical exam maneuvers like Tinel's test and imaging like MRI or electrodiagnostic testing. Conservative treatment includes splinting, anti-inflammatories, and steroid injections, while surgery to decompress the nerve through tarsal tunnel release is considered if conservative measures fail. Differential diagnoses include other causes of foot pain like Achilles tendinitis, plantar fasciitis, or lumbar nerve impingement.
Tarsal tunnel syndrome
Tarsal tunnel syndrome is a compression neuropathy of the posterior tibial nerve as it passes through the tarsal tunnel. It commonly affects middle-aged females and causes pain, burning, and numbness on the inside of the ankle and bottom of the foot. Diagnosis involves clinical tests like Tinel's sign and imaging like MRI. Treatment begins conservatively with rest, medications, splinting and nerve glides, while surgery to decompress the nerve may be needed in some cases.
Barton’s fracture Power Point
A 68-year-old female slipped in the shower, falling onto her outstretched hand and injuring her left wrist. She was found to have obvious swelling and deformity of the right wrist with limited range of motion. The diagnosis was a distal radius fracture with dislocation of the radiocarpal joint. Treatment would involve pain control, closed reduction of the fracture under sedation, and consultation with orthopedics as non-operative treatment often fails for this type of injury.
Assignment on trauma complications
A diabetic man with a history of tibia and fibula fracture treated with interlocking nail fixation 3 months ago presented with redness, swelling and foul-smelling discharge from his left leg. X-rays showed no healing of the fracture site. He was diagnosed with chronic osteomyelitis based on clinical findings and history. Management involved investigating with blood tests and imaging, surgically debriding dead tissue, administering IV antibiotics for 2-3 weeks followed by oral antibiotics for 6-8 weeks, optimizing blood sugar control, and considering implant removal or bone grafting.
Brachial plexus examination
This document outlines the steps for examining a patient's brachial plexus, including assessing muscle wasting, scarring, range of motion, sensory function, motor function, tone, myotomes, and dermatomes. Key parts of the exam involve looking for signs of atrophy, feeling for tenderness, moving each joint to test range of motion, and testing sensory and motor function through nerves like the median, ulnar, and radial. The exam is used to determine if the brachial plexus injury is pre-ganglionic or post-ganglionic and plan further investigations and treatments.
Colles’ fracture Power Point
A 52-year-old female presented to the emergency department after falling forward on an outstretched hand. She had obvious deformity to her right wrist but no lacerations. Examination revealed a distal radius fracture with dorsal displacement of the distal fragment, known as a "dinner fork deformity". Prompt orthopedic consultation was recommended for reduction if the radius could not be reduced or if there was over 1mm of intra-articular step-off, less than 15 degrees of radial inclination, volar tilt less than neutral, or over 2mm of shortening compared to the left wrist. A sugar-tong splint was applied if indicated and the patient was referred for follow-up.
ulnar Entrapment Neuropathy and double crush syndrome
Nerve entrapment occurs when a nerve becomes compressed as it travels through tight spaces in the body. The ulnar nerve is commonly entrapped at the elbow, where it passes through the cubital tunnel, or at the wrist in Guyon's canal. Symptoms include numbness, tingling, and weakness. Treatment involves modifying activities that cause compression, splinting, and sometimes surgery to decompress the nerve. The double crush syndrome can occur when a nerve is compressed at multiple sites, worsening symptoms.
OSSE Teaching for Phase V 2016
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Cubitus valgus
Cubitus valgus is a deformity where the forearm is abnormally abducted in relation to the upper arm, causing a visible defect. It is rarely seen and can result as a complication from a fractured lateral humerus condyle. Causes include previous fractures or injuries to the lower humerus that result in malunion, interference with epiphyseal growth on the lateral side, or Turner's syndrome. Left untreated, it can lead to a secondary tardy nerve palsy from friction neuritis of the ulnar nerve. Treatment options range from no intervention for mild cases, to a medial closed wedge osteotomy for moderate to severe cases, or anterior transposition surgery for any tard
Lunate dislocation
A 65-year-old female presented to the emergency department with right hand pain after falling down stairs. On examination, she had swelling of the right hand with limited motion of the wrist and hand. She was diagnosed with a lunate dislocation of the right wrist which requires emergent orthopedic consultation and may need to be repositioned in the emergency department or operating room. Complications are common after a lunate dislocation such as arthritis and wrist instability.
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This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
Mallet finger
A 27-year-old male baseball player presents with pain and swelling isolated to his right index finger DIP joint after hearing a snap during a pitch. Radiographs show a mallet finger injury with an associated avulsion fracture. The diagnosis is a mallet finger with fracture. Treatment involves splinting the DIP joint in extension for 6-10 weeks, unless the fracture is displaced more than 40% or has volar subluxation, in which case surgery may be needed. Complications can include a swan neck deformity if not treated properly.
Hands examination
The document provides instructions for examining a patient's hands. It describes examining the skin, muscles, bones and conducting range of motion tests and neurological tests including sensation and motor function tests. Special tests are described to check for ulnar nerve issues and carpal tunnel syndrome. Investigations like x-rays and nerve conduction studies are mentioned. Management is described as initially conservative with splinting and addressing secondary causes, with surgery an option for severe carpal tunnel syndrome.
Mallet Finger Power Point
A 20-year-old male presented with pain in his right index finger after a basketball hit the end of the finger. On examination, the distal interphalangeal (DIP) joint of the right index finger was swollen, tender to touch, and the patient was unable to extend the DIP joint. A diagnosis of an intra-articular avulsion fracture of the dorsal surface of the distal phalanx was made. The treatment plan included pain control, splinting the DIP joint in extension for 6-8 weeks while allowing the other finger joints to move freely, and possible surgery if the fracture involved over 25% of the articular surface.
Smith’s fracture
A 51-year-old male construction worker fell backwards and broke his wrist, presenting with swelling, deformity, and limited range of motion. He was diagnosed with an extra-articular distal radius fracture with volar angulation, also known as a Garden Spade deformity, likely from falling backwards on an outstretched hand. Treatment included pain control, closed reduction to reverse the deformity, and consultation for possible operative fixation.
Perilunate dislocation Power Point
A 67-year-old female presented with severe pain and inability to move her right wrist after falling forward onto her outstretched hand. Examination revealed profound swelling of the right wrist with tenderness over the wrist and metacarpals and limited range of motion. Imaging showed a posterior dislocation of the capitate and distal carpal row with the lunate in a normal position. Treatment involved pain management, closed reduction of the carpal dislocation with traction and dorsal pressure, and consultation with orthopedics due to the high likelihood of associated carpal fractures requiring open repair.
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Sabir nerve entrapement final
Nerve compression syndromes can affect both the upper and lower extremities. Common sites of entrapment include the carpal tunnel, cubital tunnel at the elbow, and tarsal tunnel in the foot. Symptoms include numbness, tingling, pain, and weakness. Conservative treatments include splinting, medications, and injections. Surgery is considered if symptoms do not improve with conservative care or if there is evidence of severe nerve damage. The presentation, causes, and treatment of specific compression syndromes like carpal tunnel syndrome, cubital tunnel syndrome, and tarsal tunnel syndrome were discussed in detail.
Perilunate dislocation
A 67-year-old female presented with severe right wrist pain and inability to move it after falling forward onto her outstretched hand. Examination revealed profound swelling and tenderness of the right wrist with limited range of motion. X-rays showed a posterior dislocation of the capitate and distal carpal row bones, with the lunate in a normal position. Pain management and closed reduction of the dislocation was performed, and orthopedic consultation was recommended due to the likelihood of associated carpal fractures requiring open repair.
Thumb deformity
Rheumatoid arthritis is a common inflammatory joint disease that can lead to joint deformities. The document discusses common thumb deformities caused by RA like boutonniere and swan neck deformities. Treatment options range from splinting and synovectomy for mild cases to joint fusion or arthroplasty for more severe deformities. Tendon ruptures are also addressed along with surgical techniques like tendon transfers to restore function.
Mallet finger
A 27-year-old male baseball player presents with sudden pain and swelling in his right index finger DIP joint after throwing a fastball. Examination reveals swelling and inability to fully extend the DIP joint, with normal motor function elsewhere. X-rays show a terminal extensor tendon disruption with associated avulsion fracture. Treatment is splinting the DIP joint in extension for 6-10 weeks, with surgery indicated if the fracture involves over 40% of the joint surface or there is volar subluxation.
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The document describes claw hand, which is a deformity of the hand where the fingers are flexed into the palm at the middle knuckle. It discusses the anatomy, etiology, types, clinical signs, classification, and surgical techniques for correction. The main techniques discussed are static procedures like flexor pulley advancement and dynamic procedures using tendon transfers to restore muscle function. The goal of surgery is to maintain the middle knuckle in slight flexion to allow the extensors to straighten the fingers.
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- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
OK sign
This document summarizes a proposed new physical examination technique called the Extended OK Sign (EOK). The EOK builds upon the traditional OK sign, which tests the median nerve, by incorporating additional movements to test other major hand nerves. Specifically, the EOK involves performing the OK sign followed by wrist extension to test the radial nerve, digit extension to test the posterior interosseous nerve, and digit abduction to test the ulnar nerve. Together these movements allow for a succinct screening of the major motor nerve functions of the hand using a single coordinated set of motions. While not replacing detailed neurological exams, the EOK provides a quick initial screening to identify potential motor deficits warranting further investigation.
Foot drop
This document provides information about foot drop, including its definition, causes, symptoms, diagnosis, treatment, and rehabilitation exercises. Foot drop is the inability to lift the front of the foot and can be caused by nerve damage or muscle weakness. Symptoms include dragging the front of the foot when walking. Treatment may include splinting, foot braces, exercises to strengthen muscles, electrical stimulation, or surgery in severe cases. Physical therapy focuses on exercises to improve dorsiflexion like toe curls and strengthen ankle muscles.
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A 35-year-old man fell and hit the back of his head on the ground after drinking alcohol. He was brought to the emergency room 4 hours later with pain in his head and neck. On examination, he had a 2 cm laceration on the back of his skull but was neurologically intact. Imaging showed a hangman's fracture. He was placed in a hard cervical collar, the wound was sutured, and he was started on skull traction and a Philadelphia collar for the hangman's fracture.
Cubital Tunnel Syndrome EBP
Cubital tunnel syndrome involves compression or irritation of the ulnar nerve as it passes through the cubital tunnel under the elbow. The main causes are idiopathic subluxation of the ulnar nerve or trauma/arthrosis leading to delayed paresis. Symptoms include numbness and weakness in the fourth and fifth digits. Conservative treatment involves splinting, exercises, and anti-inflammatory medication, while surgery may be considered for persistent or progressive symptoms.
G ps flexor tendon talk
This document discusses flexor tendon zones, tenosynovitis (infection of the flexor tendon sheath), and its diagnosis and treatment. Tenosynovitis most often results from penetrating trauma near joint creases. It causes purulence and adhesions within the sheath, destroying gliding and blood supply. Key signs are tenderness over the sheath, swelling of the digit, and pain with passive extension. Early cases may be treated with antibiotics but established infections require prompt surgical drainage to prevent tendon and skin necrosis.
Eyelid recon
This document describes the anatomy and reconstruction of the eyelids. It discusses:
1. The layers and structures of the eyelid including the skin, orbicularis oculi muscle, tarsal plates, levator palpebrae superioris muscle, and conjunctiva.
2. Embryology, blood supply, innervation, and cross section of the eyelid.
3. Specific structures like the orbital septum, tarsal plates, pre-aponeurotic fat, and lacrimal system.
4. Goals and requirements of eyelid reconstruction including reestablishing function, protection, cosmesis as well as anterior and posterior lamellae reconstruction techniques.
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Lunate dislocation
A 65-year-old female presented to the emergency department with right hand pain after falling down stairs. On examination, she had swelling of the right hand with limited motion of the wrist and hand. She was diagnosed with a lunate dislocation of the right wrist which requires emergent orthopedic consultation and may need to be repositioned in the emergency department or operating room. Complications are common after a lunate dislocation such as arthritis and wrist instability.
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This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
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A 27-year-old male baseball player presents with pain and swelling isolated to his right index finger DIP joint after hearing a snap during a pitch. Radiographs show a mallet finger injury with an associated avulsion fracture. The diagnosis is a mallet finger with fracture. Treatment involves splinting the DIP joint in extension for 6-10 weeks, unless the fracture is displaced more than 40% or has volar subluxation, in which case surgery may be needed. Complications can include a swan neck deformity if not treated properly.
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The document provides instructions for examining a patient's hands. It describes examining the skin, muscles, bones and conducting range of motion tests and neurological tests including sensation and motor function tests. Special tests are described to check for ulnar nerve issues and carpal tunnel syndrome. Investigations like x-rays and nerve conduction studies are mentioned. Management is described as initially conservative with splinting and addressing secondary causes, with surgery an option for severe carpal tunnel syndrome.
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A 20-year-old male presented with pain in his right index finger after a basketball hit the end of the finger. On examination, the distal interphalangeal (DIP) joint of the right index finger was swollen, tender to touch, and the patient was unable to extend the DIP joint. A diagnosis of an intra-articular avulsion fracture of the dorsal surface of the distal phalanx was made. The treatment plan included pain control, splinting the DIP joint in extension for 6-8 weeks while allowing the other finger joints to move freely, and possible surgery if the fracture involved over 25% of the articular surface.
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A 51-year-old male construction worker fell backwards and broke his wrist, presenting with swelling, deformity, and limited range of motion. He was diagnosed with an extra-articular distal radius fracture with volar angulation, also known as a Garden Spade deformity, likely from falling backwards on an outstretched hand. Treatment included pain control, closed reduction to reverse the deformity, and consultation for possible operative fixation.
Perilunate dislocation Power Point
A 67-year-old female presented with severe pain and inability to move her right wrist after falling forward onto her outstretched hand. Examination revealed profound swelling of the right wrist with tenderness over the wrist and metacarpals and limited range of motion. Imaging showed a posterior dislocation of the capitate and distal carpal row with the lunate in a normal position. Treatment involved pain management, closed reduction of the carpal dislocation with traction and dorsal pressure, and consultation with orthopedics due to the high likelihood of associated carpal fractures requiring open repair.
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What is trigger finger or Stenosing tenosynovitis? How to diagnose trigger finger? what are Annular pulleys? What are causes of it? How to treat trigger finger through physical therapy?
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Nerve compression syndromes can affect both the upper and lower extremities. Common sites of entrapment include the carpal tunnel, cubital tunnel at the elbow, and tarsal tunnel in the foot. Symptoms include numbness, tingling, pain, and weakness. Conservative treatments include splinting, medications, and injections. Surgery is considered if symptoms do not improve with conservative care or if there is evidence of severe nerve damage. The presentation, causes, and treatment of specific compression syndromes like carpal tunnel syndrome, cubital tunnel syndrome, and tarsal tunnel syndrome were discussed in detail.
Perilunate dislocation
A 67-year-old female presented with severe right wrist pain and inability to move it after falling forward onto her outstretched hand. Examination revealed profound swelling and tenderness of the right wrist with limited range of motion. X-rays showed a posterior dislocation of the capitate and distal carpal row bones, with the lunate in a normal position. Pain management and closed reduction of the dislocation was performed, and orthopedic consultation was recommended due to the likelihood of associated carpal fractures requiring open repair.
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Rheumatoid arthritis is a common inflammatory joint disease that can lead to joint deformities. The document discusses common thumb deformities caused by RA like boutonniere and swan neck deformities. Treatment options range from splinting and synovectomy for mild cases to joint fusion or arthroplasty for more severe deformities. Tendon ruptures are also addressed along with surgical techniques like tendon transfers to restore function.
Mallet finger
A 27-year-old male baseball player presents with sudden pain and swelling in his right index finger DIP joint after throwing a fastball. Examination reveals swelling and inability to fully extend the DIP joint, with normal motor function elsewhere. X-rays show a terminal extensor tendon disruption with associated avulsion fracture. Treatment is splinting the DIP joint in extension for 6-10 weeks, with surgery indicated if the fracture involves over 40% of the joint surface or there is volar subluxation.
Susil seminar claw hand
The document describes claw hand, which is a deformity of the hand where the fingers are flexed into the palm at the middle knuckle. It discusses the anatomy, etiology, types, clinical signs, classification, and surgical techniques for correction. The main techniques discussed are static procedures like flexor pulley advancement and dynamic procedures using tendon transfers to restore muscle function. The goal of surgery is to maintain the middle knuckle in slight flexion to allow the extensors to straighten the fingers.
Ortho..
- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
OK sign
This document summarizes a proposed new physical examination technique called the Extended OK Sign (EOK). The EOK builds upon the traditional OK sign, which tests the median nerve, by incorporating additional movements to test other major hand nerves. Specifically, the EOK involves performing the OK sign followed by wrist extension to test the radial nerve, digit extension to test the posterior interosseous nerve, and digit abduction to test the ulnar nerve. Together these movements allow for a succinct screening of the major motor nerve functions of the hand using a single coordinated set of motions. While not replacing detailed neurological exams, the EOK provides a quick initial screening to identify potential motor deficits warranting further investigation.
Foot drop
This document provides information about foot drop, including its definition, causes, symptoms, diagnosis, treatment, and rehabilitation exercises. Foot drop is the inability to lift the front of the foot and can be caused by nerve damage or muscle weakness. Symptoms include dragging the front of the foot when walking. Treatment may include splinting, foot braces, exercises to strengthen muscles, electrical stimulation, or surgery in severe cases. Physical therapy focuses on exercises to improve dorsiflexion like toe curls and strengthen ankle muscles.
Noon conference hangman
A 35-year-old man fell and hit the back of his head on the ground after drinking alcohol. He was brought to the emergency room 4 hours later with pain in his head and neck. On examination, he had a 2 cm laceration on the back of his skull but was neurologically intact. Imaging showed a hangman's fracture. He was placed in a hard cervical collar, the wound was sutured, and he was started on skull traction and a Philadelphia collar for the hangman's fracture.
Cubital Tunnel Syndrome EBP
Cubital tunnel syndrome involves compression or irritation of the ulnar nerve as it passes through the cubital tunnel under the elbow. The main causes are idiopathic subluxation of the ulnar nerve or trauma/arthrosis leading to delayed paresis. Symptoms include numbness and weakness in the fourth and fifth digits. Conservative treatment involves splinting, exercises, and anti-inflammatory medication, while surgery may be considered for persistent or progressive symptoms.
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1. The layers and structures of the eyelid including the skin, orbicularis oculi muscle, tarsal plates, levator palpebrae superioris muscle, and conjunctiva.
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4) Interossei muscles abduct and adduct the fingers at the MCP and PIP joints.
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Squamous cell carcinoma (SCC) is the second most common skin cancer. It has a propensity to metastasize, making it responsible for most skin cancer deaths. Risk factors include UV exposure, age, immunosuppression, and primary dermatoses. Histological subtypes include pleomorphic, adenoid, small cell, verrucous, and keratoacanthoma. Tumor size greater than 2 cm and depth greater than 6 mm increase metastatic risk. Treatment involves surgical excision with adequate margins or other modalities like radiation for high risk cases.
Body contouring
A 48-year-old man who lost 200 kg through diet and exercise underwent a lower body lift. During the 4-hour, 2-surgeon procedure, he required repositioning 3 times and 6 drains. Post-operatively he developed hemorrhages requiring exploration. He was discharged after 8 days requiring weekly drainage of seromas. The document discusses nutritional deficiencies common after bariatric surgery that can impact wound healing for body contouring procedures. It notes diet and exercise patients have higher complication rates than those who had bariatric surgery. Careful patient evaluation and counseling is important due to the risks and limitations of massive weight loss body contouring.
Radial nerve anatomyw
The radial nerve originates from cervical and thoracic nerve roots and is the largest branch of the brachial plexus. It provides cutaneous innervation to the posterior arm and forearm and motor innervation to triceps, brachioradialis, and extensor muscles of the forearm and hand. The radial nerve is vulnerable to compression at the radial tunnel as it travels through the forearm. Compression can cause radial tunnel syndrome. The superficial branch of the radial nerve can be affected by Wartenberg syndrome. Radial nerve palsy can result from fractures, injuries, tumors, or iatrogenic causes.
Mucous cysts dip jw
Mucous cysts of the DIPJ usually occur in older adults and are associated with osteoarthritis. They contain mucin and form from degeneration of joint structures. Clinically, they appear as nodules near the DIPJ that can cause nail deformities. Treatment involves surgical excision, sometimes with additional procedures like osteophyte removal. Complications include residual deformities, stiffness, skin issues, and recurrence due to incomplete excision or persistent arthritis.
Carpal tunnel
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel. While open carpal tunnel release was previously the standard treatment, endoscopic carpal tunnel release has gained popularity as an alternative. Multiple reviews have found no difference in symptom relief between the two techniques. Evidence is conflicting on whether endoscopic surgery results in earlier return to work. Endoscopic surgery is associated with a higher risk of reversible median nerve injury but results in superior grip strength and less scar tenderness in the short term. Further research is still needed to make definitive conclusions about the relative effectiveness of open versus endoscopic carpal tunnel release.
Lower limb flapsw
This document describes the arterial blood supply and potential flaps in the lower limb. It discusses various fasciocutaneous and musculocutaneous flaps that can be raised based on named arteries in the lower limb, including the femoral, lateral circumflex femoral, profunda femoris, popliteal, and posterior tibial arteries. Specific flaps are described such as the anteromedial thigh flap, gracilis flap, and gastrocnemius flap. The angiosome concept and variations in vascular anatomy are also covered.
Scaphoid fracturesw
Scaphoid fractures are the most common carpal bone fractures, often occurring in young adults from falls on an outstretched hand. The scaphoid has a tenuous blood supply and is prone to non-union, especially for proximal pole fractures. Treatment depends on fracture type and stability, ranging from casting to operative fixation with screws. Complications include malunion, delayed union, non-union and avascular necrosis, requiring further procedures like bone grafting or carpal fusion.
Economic viability of_autologous_breast_reconstruction_final
This document summarizes the results of a retrospective audit assessing the financial implications of breast reconstruction procedures. It analyzed 274 patients who underwent 278 primary breast reconstructions and 366 secondary procedures between 2000-2007. DIEP flap reconstruction had the longest average length of stay but also the highest costs. Implant reconstruction had fewer secondary procedures on average but costs were still substantial due to additional procedures needed. The document concludes that while autologous reconstruction provides better long-term symmetry, the current tariff system financially discourages immediate and bilateral breast reconstruction procedures.
Skin graftsw
This document discusses the physiology and process of skin grafts. It describes the layers of skin - epidermis and dermis - and their functions. It explains the classification of different types of skin grafts including full thickness and split thickness grafts. The document then outlines the four phases of "take" that a skin graft undergoes as it revascularizes and attaches to the recipient bed. It provides details on the histological and structural changes that occur in the epidermis and dermis during the healing process over subsequent days and weeks. Factors that influence graft survival and potential causes of graft failure are also summarized.
Fellowship talk moradi
Akademikliniken (AK) is a plastic surgery clinic in Stockholm with two centers and over 100 employees. They offer a 1-year unpaid fellowship that provides housing and meals. Starting this year, the fellowship will be formalized into a paid 1-year program. The fellow would assist with over 4,500 operations per year, primarily aesthetic procedures. In Moradi's 4.5 month fellowship, he assisted with over 300 cases across facial aesthetics, breast procedures, body contouring surgeries, and free flaps. The clinic also hosts monthly masterclasses and social events for fellows and surgeons.
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Similar to Anatomy ulnar nerve
Entrapment syndromes
these are the various entrapment syndromes we come across in orthopaedics. starting with general information of all entrapments
Entrapment neuropathy of the upper limb
1. Entrapment neuropathies occur when nerves are compressed, most commonly the median nerve at the carpal tunnel or the ulnar nerve at the elbow.
2. Symptoms depend on the affected nerve but typically begin with tingling and pain, followed by numbness and possible muscle weakness.
3. Carpal tunnel syndrome results from median nerve compression at the wrist and is the most common upper limb neuropathy. Treatment involves splinting, injections, or surgery to release the transverse carpal ligament.
Compressive neuropathies of upper limb
Etiology, Anatomy , clinical presentation , examination ,provocative tests , Diagnosis , conservative and surgical management of all entrapment neuropathies of upper limb.
JC on Cubital Tunnel Syndrome.pptx
Cubital Tunnel Syndrome involves compression or traction of the ulnar nerve around the elbow, causing loss of sensation and muscle weakness in the hand. Non-surgical treatments include splinting and avoiding aggravating activities, which help in mild cases. Surgical treatment may be needed if symptoms are constant or worsening, and includes simple nerve decompression or transposition of the nerve. Recurrence rates after surgery can be as high as 19%, so prevention of iatrogenic nerve damage during surgery is important. Studies have found similar outcomes for nerve function recovery with decompression versus transposition procedures.
JC on Cubital Tunnel Syndrome.pptx
Cubital Tunnel Syndrome involves compression or traction of the ulnar nerve around the elbow, causing loss of sensation and muscle weakness in the hand. Non-surgical treatments include splinting and avoiding aggravating activities, which help in mild cases. Surgical treatment may be needed if symptoms are constant or worsening, and includes simple nerve decompression or transposition of the nerve. Recurrence rates after surgery can be as high as 19%, so prevention of iatrogenic nerve damage during surgery is important. Studies have found similar outcomes for nerve function recovery with decompression versus transposition procedures.
Approach to Hand Conditions
This document provides an overview of approaches to assessing and treating various hand conditions. It discusses:
- Taking a thorough history including pain characteristics, deformities, range of motion, weaknesses, and hobbies/job.
- Performing a physical exam of the hand including assessing the skin, vessels, nerves, muscles/tendons, and bones/joints.
- Common traumatic hand injuries like distal radius fractures, scaphoid fractures, and Bennett's thumb fractures. Peripheral nerve injuries and compressive neuropathies like carpal tunnel syndrome are also reviewed.
- Common masses found in the hand such as ganglions, giant cell tumor of tendon sheath, and epidermoid
Wrist and hand disordes....5 th stage [dr.farouk
This document provides an overview of common wrist and hand disorders presented by Dr. Farouq Makkie Alyouzbaki. It discusses the anatomy of the wrist and hand, common conditions such as De Quervain's tenosynovitis, carpal tunnel syndrome, and ganglions. Treatment approaches for various disorders are presented such as splinting, corticosteroid injections, and surgical releases. The document also covers hand infections, congenital anomalies, and other tendon and joint conditions that can affect the wrist and hand.
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar tunnel syndrome, also known as cubital tunnel syndrome, involves compression or irritation of the ulnar nerve at the elbow, causing tingling, numbness, and pain in the forearm and fingers. It is most often caused by repetitive elbow flexion or trauma. Physical therapy focuses on ulnar nerve gliding exercises, manual therapy, splinting the elbow at 45 degrees for 4-6 weeks, heat, stretching, and strengthening exercises to relieve symptoms while avoiding aggravating activities. Conservative treatment is effective for most acute cases.
Ulnar Nerve Injury.pptx
This document provides an overview of ulnar nerve injury, including:
- Anatomy of the ulnar nerve and the muscles it innervates
- Common causes of ulnar nerve injury such as trauma, compression neuropathies like cubital tunnel syndrome
- Clinical signs of ulnar nerve injury including clawing of the ring and little fingers
- Surgical management options like nerve repair, grafting, decompression for compression neuropathies, and tendon transfers to restore hand function
- Specific procedures for cubital tunnel syndrome and ulnar tunnel syndrome decompression
Hand & elbow injuries
This document discusses injuries to the elbow, including anatomy and common injuries such as lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), elbow dislocations, Volkmann's ischemic contracture, and carpal tunnel syndrome. It provides details on the causes, symptoms, and treatments for each injury. The document also covers elbow injury assessment techniques including history, observation, palpation, range of motion testing, and resisted muscle tests. Lastly, it discusses elbow injury prevention strategies such as wearing braces, proper warm-ups including stretching, knowing your body, and changing up your routine.
7 compression neuropathy.pptx
This document discusses various types of peripheral nerve injuries including compression neuropathies. It describes common sites of nerve compression including the carpal tunnel, cubital tunnel, and radial tunnel. Carpal tunnel syndrome is the most common upper extremity compression neuropathy and symptoms include numbness and pain in the distribution of the median nerve. Treatment involves activity modification, splinting, injections, and potentially surgical release of the transverse carpal ligament. Cubital tunnel syndrome involves compression of the ulnar nerve in the elbow and treatment may involve decompression of the nerve. Radial, anterior interosseous, and other peripheral nerve compressions are also outlined.
Median Nerve Injury and Carpal Tunnel Syndrome
Carpal tunnel syndrome results from median nerve compression in the carpal tunnel of the wrist. It is caused by narrowing of the tunnel or swelling of its contents. Symptoms include numbness, tingling and pain in the hand and fingers. Conservative treatments include splinting and steroid injections while surgery involves cutting the transverse carpal ligament to relieve pressure on the median nerve. Recurrence after surgery can occur due to incomplete release, scarring or persistent swelling.
median nerve power point presentation.pptx
This document discusses the anatomy and injuries of the median nerve. It begins with the anatomy of the median nerve as it travels from the axilla to the forearm. It then discusses high and low injuries to the median nerve and their associated motor and sensory deficits. Examination techniques like the pronator teres assessment and Kleinert test are described. Median nerve compression syndromes like carpal tunnel syndrome are also covered. The document concludes with discussing indications for median nerve surgery, timing of surgery, and critical limits for delayed repair.
Carpal tunnel syndrome
Carpal tunnel syndrome results from compression of the median nerve as it passes through the carpal tunnel in the wrist. It commonly causes tingling, numbness, and pain in the hand and fingers. Treatment involves splinting, steroid injections, and surgery to release the transverse carpal ligament if more conservative treatments are unsuccessful. Carpal tunnel release surgery involves dividing the ligament to decompress the median nerve and relieve symptoms.
Ulnar nerve injury PPT
The document provides information about ulnar nerve injury, including its course through the upper limb, branches and sensory/motor supply. Causes of injury include compression at sites like the elbow (cubital tunnel syndrome) and wrist (Guyon's canal syndrome). Signs and symptoms involve sensory loss and weakness of hand muscles. Clinical tests assess functions like pinching. Investigations include EMG, nerve conduction studies and imaging. Claw hand deformity can occur with severe ulnar nerve injury.
Elbow Pain
This document summarizes common conditions that affect the elbow joint. It describes the anatomy of the elbow joint and its major muscles, ligaments and nerves. It then discusses specific conditions like olecranon bursitis, tennis elbow, golfer's elbow, cubital tunnel syndrome, and elbow dislocations. For each condition, it provides details on symptoms, examinations, and treatment options both conservative and surgical.
Assessing mononeuropathy
This document discusses how to assess injuries to three main nerves of the forearm - the radial, median, and ulnar nerves. For each nerve, it describes the origin, pathway, functions enabled, and characteristic deformities if the nerve is severed. Tests are provided to evaluate motor function, sensory loss, and specific deformities for injuries involving each nerve. These include assessing wrist drop for radial nerve injuries, clasping and pinching tests for median nerve injuries, and clawing deformities for ulnar nerve injuries. Lymph nodes that drain the respective regions are also mentioned.
regonal pain (1) (1).pptx..............
1. The document provides information on examining the shoulder, elbow, wrist, and hand, including anatomy, inspection, palpation, range of motion tests, and special tests.
2. Common causes of pain in these areas are described, including rotator cuff injuries, arthritis, tendinitis, bursitis, and neurological issues.
3. Examination techniques for each area include inspection for deformities, swelling, atrophy; palpation for temperature, tenderness, crepitus; and range of motion and special tests like impingement signs and drop arm test for shoulders.
Cubital tunnel syndrome ( final)
A brief topic presentation I made about Cubital Tunnel Syndrome, its definition, anatomy, causes, clinical features, risk factors, diagnosis, differential diagnosis and treatment. This presentation was done at the HSA staff in Cayman Islands
Shoulder Disorders
Describing some of the most important disorders of the shoulder area: frozen shoulder, biceps tenosynovitis, biceps tendon tear, rotator cuff tear, impingement syndrome, Rotator Cuff Calcified Tendonitis
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Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
Ulnar Tunnel Syndrome (Cubital Tunnel Syndrome).pptx
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Intro to-plastics
Plastic and reconstructive surgery aims to restore form and function through surgical techniques. The key areas covered are anatomy of skin circulation via perforators, angiosomes, and vascular territories; skin physiology and function; and the reconstructive ladder of closure techniques from primary closure to grafts and flaps. Flaps maintain an intrinsic blood supply unlike skin grafts.
Carpal tunnel
Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel. While open carpal tunnel release has traditionally been used to treat carpal tunnel syndrome, endoscopic carpal tunnel release is an alternative technique. Reviews of randomized controlled trials have found no clear difference in relief of symptoms between the two techniques. The evidence is conflicting on whether endoscopic carpal tunnel release results in earlier return to work compared to open release. Endoscopic release may provide superior short-term grip strength and less scar tenderness but risks more reversible median nerve injuries. Further research is still needed to make definitive conclusions.
Swan neck deformityw
Swan neck deformity is characterized by hyperextension of the proximal interphalangeal (PIP) joint and flexion of the distal interphalangeal (DIP) joint. It results from intrinsic tightness and extensor tendon imbalance caused by rheumatoid arthritis (RA). Management involves preventing further PIP hyperextension, restoring DIP extension, and addressing any underlying joint problems or soft tissue tightness based on the classification and pathophysiology. Surgical options range from splinting to tendon procedures to joint replacement depending on the severity of deformity and functional impairment.
Zplasty
Z-plasty is a surgical technique used to close wounds where two triangular flaps based on a shared limb are transposed to close each other's defects, increasing the length of scars. The degree of elongation depends on the angle of the flaps, with greater angles providing more lengthening up to 125% for 90 degree flaps. Multiple opposing or adjacent Z-plasties can be combined for even greater lengthening effect.
Radial nerve palsy tendon transfersw
This document discusses tendon transfers, which involve detaching the tendon of a functioning muscle and reattaching it to replace the function of a paralyzed muscle. The key points are:
1. Tendon transfers work to correct issues like instability, imbalance, lack of coordination, and restore function.
2. They are indicated for paralyzed muscles due to nerve injury, neurological disease, or nerve repair with early transfer. They are also used for injured tendons or muscles.
3. General principles include only restoring functional hand motion, considering patient factors, ensuring the recipient site is suitable, matching the donor muscle properties, and immobilizing initially to reduce tension.
Pipjw
This document discusses the anatomy and injuries of the proximal interphalangeal joint (PIPJ). The PIPJ is stabilized by articular contours, ligaments including the collateral and volar plate ligaments, and adjacent tendons. Dorsal dislocations of the PIPJ can be classified as Type I-III depending on the degree of ligament disruption and presence of fractures. Treatment depends on whether the injury is open or closed, stable or unstable, and may involve splinting, traction, pinning, open reduction and internal fixation, or tenodesis. Complications can include redisplacement, angular deformity, contractures, and stiffness.
Perineal reconstruction
Perineal reconstruction after pelvic surgery aims to restore form and function through flap reconstruction. The VRAM flap provides reliable vascularity, bulk, and a large skin paddle, making it the first choice for reconstruction. A study found VRAM flaps had significantly fewer complications than thigh flaps for perineal defects. Other flap options include the gracilis, posterior thigh, and perforator flaps from the gluteal arteries. Proper postoperative care is needed to ensure flap survival.
Parotid glandw
The document discusses the anatomy and tumours of the parotid gland. It describes the location and lobes of the parotid gland, its blood supply and innervation. It then discusses the various types of tumours that can occur in the parotid gland and other salivary glands, including pleomorphic adenoma, Warthin's tumour, mucoepidermoid carcinoma, adenoid cystic carcinoma, and metastatic carcinomas. It provides details on the histology, presentation and characteristics of these tumour types.
Orbital fracturesw
Orbital fractures involve breaks in the bones surrounding the eye socket. The orbital anatomy consists of 7 bones that form the pyramid-shaped orbit. Common types of orbital fractures include fractures of the orbital floor, medial wall, and lateral wall. Signs and symptoms vary depending on the structures involved but may include diplopia, limited eye movement, numbness, and vision changes. Evaluation involves history, exam of cranial nerves and eye movement, and CT scan. Treatment depends on findings but may involve initial management with ice and antibiotics followed by surgery to repair the fracture if indicated to address issues like diplopia or enophthalmos. Surgical approaches and potential complications are discussed.
Nsw speech path talk flapvs grafts
Flaps and grafts are used in reconstructive surgery to restore form and function. A flap maintains its blood supply, while a graft does not. There are several types of flaps characterized by their tissue components and blood supply. Free flaps use tissue transferred without a pedicle, while pedicled flaps maintain an attachment. Reconstructive procedures aim to separate cavities, restore function, and provide aesthetically pleasing results with minimal complications. Specific flap choices are tailored to the goals and defects in pharyngeal, mandibular, facial, and tongue reconstruction.
Lower limb flapsw
This document describes the arterial blood supply to the lower limbs and various flap options based on these arteries. It outlines the vascular anatomy of arteries like the femoral artery and its branches, including the lateral circumflex femoral artery. It then provides details on specific musculocutaneous and fasciocutaneous flap options based on these arteries, such as the anteromedial thigh flap, anterolateral thigh flap, gracilis flap, and hamstring flaps.
G ps suture workshop
The document provides guidance on suturing techniques. It recommends everting the skin edges when suturing to achieve better dermal apposition, improved healing, and a finer scar. A triangular suture passage with the base located deeply is suggested to evert the wound edges, while an inverted triangular shape tends to invert them. Dermal sutures are recommended first to reduce tension before cutaneous sutures. Adjusting where the knot lies can help flatten steps between uneven wound edges. The document also reviews appropriate suture materials for different areas, recommending absorbable sutures that elicit minimal tissue reaction for the face and longer-absorbing sutures for prone areas like the back.
Hand infections
Hand infections were a major cause of disability before antibiotics. Kanavel defined hand anatomy and drainage techniques. Penicillin reduced severe infections. Antibiotics alone rarely cure infections beyond 48 hours due to vessel thrombosis and pressure in closed spaces. Felons and paronychia each account for 1/3 of hand infections and usually result from minor trauma introducing Staph aureus. Flexor tenosynovitis is a surgical emergency to prevent tendon damage. Deep space infections involve the palmar, dorsal, thenar and midpalmar spaces and spread if not drained properly.
Jejunum asc presentation
1. The authors present their 10-year experience with 43 jejunal free flaps for reconstruction following pharyngolaryngectomy.
2. They report a 100% acute flap survival rate and an overall benign fistula rate of 4.7%. No fistulas occurred in patients who received a prophylactic pectoralis major muscle flap after radiotherapy.
3. Using a gastrointestinal stapler for the proximal and distal anastomoses was associated with a lower fistula rate compared to hand-sewn anastomoses.
Flaps in the hand
The document discusses various local flap options for reconstructing fingertip injuries. It describes the anatomy of the fingertip and goals of reconstruction which are to close wounds, maximize sensation, preserve length and function. Local flap options mentioned include volar V-Y flaps, bilateral V-Y flaps, cross-finger flaps, thenar flaps and lateral island flaps. Choice of flap depends on wound orientation and configuration.
Flap classification
This document discusses different methods of classifying flaps used in reconstructive surgery. It describes classification based on composition, proximity to the defect, method of movement, and vascular anatomy. Specific types of flaps are also outlined including local, regional, distant, and free flaps as well as fascio/cutaneous and musculocutaneous flaps. Arterial supply, types of movement including advancement, transposition, and rotation are summarized.
Fingertip recon
This document discusses reconstructive options for fingertip injuries. The goals of reconstruction are to close wounds, maximize sensory return, preserve length and joint function, and obtain a cosmetic appearance. Options include healing by secondary intention, skin grafting, and local flap reconstruction using flaps such as volar V-Y flaps, bilateral V-Y flaps, cross-finger flaps, and thenar flaps. Major complications are hypersensitivity and cold intolerance, which usually resolve after 1-2 years.
Hand tumoursw
The document discusses common hand tumours such as ganglion, giant cell tumour of tendon sheath, and epidermoid inclusion cysts. It provides details on clinical presentation, investigations, classification systems, and treatment approaches for various bone and soft tissue tumours that can occur in the hand. Common malignant tumours of the hand discussed include synovial sarcoma, clear cell sarcoma, chondrosarcoma, and osteosarcoma.
More from drmoradisyd (18)
Anatomy ulnar nerve
- 2. Anatomy of Ulnar Nerve
- 22. Cubital Tunnel Syndrome • Symptoms & Signs: - sensory changes volar & dorsal ulnar 11/2 digits - Pain or Tinel’s sign at elbow - Positive elbow flexion test - weakness/atrophy of intrinsic muscles (esp. key pinch) - Wartenberg’s sign - Froment’s sign - Claw hand
- 23. Cubital Tunnel Syndrome • Sites of compression: - Arcade of Struthers - Medial head of triceps - Medial intermuscular septum - Arcuate lig. Of Osbourne - Aponeurosis of FCU
- 26. Cubital Tunnel Syndrome • Non-surgical management - night splints to keep elbow extended (static) - Soft elbow pads to prevent direct compression - Rest & activity modification - Anti-inflammatories
- 27. Cubital Tunnel Syndrome • Surgery - Principles: - Release of compression - Prevention of subluxation
- 28. Cubital Tunnel Syndrome • Surgery: - Simple decompression in situ - Medial epicondylectomy - Anterior transposition: - subcutaneous - intramuscular - submuscular - transmuscular
- 35. Ulnar Tunnel Syndrome (Guyon’s canal) • Symptoms & signs: - numbness volar surface ulnar 1.5digits - Intrinsic weakness - Can be pure motor, pure sensory or combination
- 37. Ulnar Tunnel Syndrome (Guyon’s canal) • Aetiology: - carpal ganglion - Repetitive trauma - Fracture of hook of hamate - Hypertrophied palmaris brevis - Thrombosis or aneurysm of ulnar artery
- 38. Ulnar Tunnel Syndrome (Guyon’s canal) • Surgery: - Release of Guyon’s canal - Ensure visualization of deep motor branch - Check for ganglion