WordNet

force a way through
a passageway through or under something, usually underground (especially one for trains or cars); "the tunnel reduced congestion at that intersection"
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
the inner and longer of the two bones of the human forearm (同)elbow bone
relating to or near the ulna

PrepTutorEJDIC

『トンネル』,地下道,坑道 / 〈山など〉‘に'トンネルを掘る / 〈トンネルなど〉‘を'掘る / トンネルを掘る
(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
(人の腕,動物の前肢の)尺骨

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/08/08 16:04:33」(JST)

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Cartoon depiction of classic ulnar sensory distribution, including mid-4th and 5th fingers. Note that this diagram does not portray hand muscles affected by ulnar neuropathy.

Ulnar tunnel syndrome, also known as Guyon's canal syndrome or Handlebar palsy, is caused by entrapment of the ulnar nerve in the Guyon canal as it passes through the wrist.^[1] Symptoms usually begin with a feeling of pins and needles in the ring and little fingers before progressing to a loss of sensation and/or impaired motor function of the intrinsic muscles of the hand which are innervated by the ulnar nerve. Ulnar tunnel syndrome is commonly seen in regular cyclists due to prolonged pressure of the Guyon's canal against bicycle handlebars. Another very common cause of sensory loss in the ring and pink finger is due to ulnar nerve entrapment at the Cubital Tunnel near the elbow, which is known as Cubital Tunnel Syndrome.

Classification

Ulnar tunnel syndrome may be characterized by the location or zone within the Guyon's canal at which the ulnar nerve is compressed. The nerve divides into a superficial sensory branch and a deeper motor branch in this area. Thus, Guyon's canal can be separated into three zones based on which portion of the ulnar nerve are involved. The resulting syndrome results in either muscle weakness or impaired sensation in the ulnar distribution.^[1]

	Location	Symptoms	Associations
Zone 1	Proximal (prior to ulnar nerve bifurcation)	Mixed motor & sensory	Ganglia & hook of hammate fractures
Zone 2	Surrounding deep motor branch ulnar nerve	Motor only	Ganglia & hook of hammate fractures
Zone 3	Surrounding superficial sensory branch of ulnar nerve	Sensory only	Ulnar artery pathology

Zone 2 type syndromes are most common, while Zone 3 are least common.

Treatment

Chiropractic, physical therapy, occupational therapy, massage therapy and osteopathic care are a common start to musculoskeletal treatment programs because they work directly with the areas affected (muscles, fascia and skeleton).^[2]^[3]^[4] All of these treatments can be both cost-effective and produce minimal negative side effects. If these options do not produce the desired results, some doctors may recommend working with a pharmaceutical or surgical option.

Initial line of treatment is with anti-inflammatory drugs or cortisone injections. There have been trials with gloves which help protect the ulnar nerve from compression. The most radical treatment option is surgery to relieve tension in the volar carpal ligament which forms the roof of Guyon's canal, thereby reducing compression on the ulnar nerve.^[5]

References

^ ^a ^b Hatch, Daniel (August 20, 2014). "Ulnar Tunnel Syndrome". Orthobullets. Retrieved Sep 7, 2014.
^ http://www.webmd.com/pain-management/guide/musculoskeletal-pain
^ http://www.massagetherapy.com/articles/index.php/article_id/1918/Massage-Science-and-Your-Health
^ http://www.medscape.com/viewarticle/747199
^ Okutsu, I.; Hamanaka, I.; Yoshida, A. (2009). "Pre- and Postoperative Guyon's Canal Pressure Change in Endoscopic Carpal Tunnel Release: Correlation with Transient Postoperative Guyon's Canal Syndrome". Journal of Hand Surgery. 34 (2): 208–11. PMID 19282410. doi:10.1177/1753193408100122.

UpToDate Contents

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1. 肘および手首の尺骨神経障害 ulnar neuropathy at the elbow and wrist
2. 急性の手首の疼痛を有する成人患者の評価 evaluation of the adult with acute wrist pain
3. 手関節の筋骨格超音波検査 musculoskeletal ultrasound of the wrist
4. 尿毒症性単神経障害 uremic mononeuropathy
5. 亜急性または慢性の手首の疼痛を有する成人の評価 evaluation of the adult with subacute or chronic wrist pain

English Journal

Premotor Potential Study for Diagnosis of Carpal Tunnel Syndrome.

Kodama M1, Tochikura M, Shimoda N, Fujii C, Fujiwara T, Masakado Y.
The Tokai journal of experimental and clinical medicine.Tokai J Exp Clin Med.2016 Jun 20;41(2):101-7.
INTRODUCTION: The second lumbrical-interossei latency difference test (2LINT) is used frequently for electrodiagnosis of carpal tunnel syndrome (CTS). A premotor potential observed with 2LINT has been identified as a median-nerve sensory nerve action potential. We evaluated the utility of the premot
PMID 27345002

Postoperative improvement in DASH score, clinical findings, and nerve conduction velocity in patients with cubital tunnel syndrome.

Ido Y1, Uchiyama S2, Nakamura K3, Itsubo T4, Hayashi M2, Hata Y3, Imaeda T5, Kato H2.
Scientific reports.Sci Rep.2016 Jun 6;6:27497. doi: 10.1038/srep27497.
We investigated a recovery pattern in subjective and objective measures among 52 patients with cubital tunnel syndrome after anterior subcutaneous transposition of the ulnar nerve. Disabilities of the Arm, Shoulder and Hand (DASH) score (primary outcome), numbness score, grip and pinch strength, Sem
PMID 27263860

Factors affecting finger and hand pain in workers with HAVS.

House R1, Krajnak K2, Jiang D3.
Occupational medicine (Oxford, England).Occup Med (Lond).2016 Jun;66(4):292-5. doi: 10.1093/occmed/kqw022. Epub 2016 Feb 28.
BACKGROUND: Pain and its management are important aspects of hand-arm vibration syndrome (HAVS).AIMS: To determine the factors associated with finger and hand pain in workers with HAVS and, specifically, to assess the impact of several neurological variables as well as the vascular component of HAVS
PMID 26928857