Overview
what it is and why it matters
Guyon's canal syndrome is compression of the ulnar nerve as it passes through Guyon's canal at the ulnar (pinky) side of the wrist. Symptoms include numbness and tingling in the ring and little fingers, weak grip, and difficulty with fine pinch. It is far less common than carpal tunnel syndrome but often coexists with it.
Common causes include a ganglion cyst pressing on the canal, a hook-of-hamate fracture, repetitive pressure from cycling handlebars, or prolonged wrist use on hard surfaces.
Diagnosis
exam first, imaging secondTinel's sign over Guyon's canal and sensory testing of the ring and little fingers guide diagnosis. NCS/EMG localizes compression and distinguishes it from cubital tunnel syndrome or ulnar neuropathy at the elbow. X-ray and CT may reveal a hamate fracture; MRI identifies soft-tissue masses.
Treatment Path
how care progresses at OSI1
Activity modification
Padded cycling gloves, wrist rest changes, and avoiding direct pressure on the ulnar wrist.
2
Wrist splinting
Keeping the wrist in neutral reduces tension on the ulnar nerve.
3
Corticosteroid injection
May help when inflammation or a cyst is contributing.
Surgical Options at OSI
if non-operative care isn't enoughSurgical decompression is indicated for a space-occupying lesion (cyst, lipoma), hook-of-hamate fracture nonunion, or persistent symptoms not responding to conservative care.
Providers Who Treat Guyon's Canal Syndrome
sports-medicine team
David B. Templin, M.D.
Trent Twitero, M.D.
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: