Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.
Faculty of Health Care Sciences, Himeji Dokkyo University, 7-2-1 Kami-ono, Himeji, 670-8524, Japan.
Anat Sci Int. 2021 Jun;96(3):422-426. doi: 10.1007/s12565-021-00607-w. Epub 2021 Feb 6.
The ulnar tunnel (Guyon's canal) is an osseofibrous tunnel for the ulnar nerve and artery. With regard to the proximal palmar wall (palmar carpal ligament) of the ulnar tunnel, detailed anatomical data such as attachment sites, fibrous continuity to surroundings, and variations have not been clearly described. In this study, topology of Guyon's canal was examined, especially to the palmar side of the ulnar nerve, focusing on the continuity of tendinous structures to reveal a more detailed constitution of Guyon's canal. The palmar wall of Guyon's canal was investigated in 113 forearms of 57 cadavers. The dorsal wall of the canal was also investigated in 25 subjects. The ulnar nerve passed lateral to the pisiform and the flexor carpi ulnaris tendon. At the level of the pisiform, except for one, the ulnar nerve passed dorsal to the aponeurosis expanding from the flexor carpi ulnaris tendon and the periosteum of the pisiform, and this aponeurosis laterally merged with the palmar aspect of the flexor retinaculum. Moreover, the ulnar nerve ran palmar to the pisohamate ligament and the flexor retinaculum extended from the same tendon. The present study suggests that the aponeurosis of palmar side to the ulnar nerve connected with the flexor carpi ulnaris tendon, the periosteum of the pisiform, and the palmar surface of the flexor retinaculum. These findings indicate that the ulnar nerve is surrounded by the aponeurotic portion expanding from the flexor carpi ulnaris tendon at the wrist, which is a new insight of Guyon's canal.
尺管（Guyon 管）是尺神经和动脉的骨纤维隧道。关于尺管近掌侧壁（腕尺侧韧带），其附着点、与周围纤维的连续性以及变异等详细解剖学数据尚未明确描述。在这项研究中，我们检查了 Guyon 管的拓扑结构，特别是尺神经的掌侧，重点研究了腱结构的连续性，以揭示 Guyon 管的更详细结构。我们研究了 57 具尸体的 113 例前臂的 Guyon 管掌侧壁。还研究了 25 例受试者的尺管背侧壁。尺神经位于豌豆骨的外侧和尺侧腕屈肌肌腱的下方。在豌豆骨水平，除了一例外，尺神经都位于从尺侧腕屈肌肌腱和豌豆骨骨膜延伸的腱膜的背侧，该腱膜与屈肌支持带的掌侧外侧融合。此外，尺神经位于豌豆钩骨韧带的掌侧，屈肌支持带从同一肌腱延伸。本研究表明，尺神经掌侧的腱膜与尺侧腕屈肌肌腱、豌豆骨骨膜和屈肌支持带的掌面相连。这些发现表明，尺神经在腕部被从尺侧腕屈肌肌腱延伸的腱膜性部分所环绕，这是对 Guyon 管的新认识。
