Gasparo Ettore, Gustar Adrian, Atzeni Matteo, Serra Pietro Luciano, Boriani Filippo
Plastic Surgery and Microsurgery Unit, Department of Surgical Sciences, Faculty of Medicine and Surgery, University Hospital "Duilio Casula", University of Cagliari, 09124 Cagliari, Italy.
Plastic Surgery Unit, Department of Medical, Surgical and Experimental Sciences, Sassari University Hospital Trust, University of Sassari, 07100 Sassari, Italy.
Reports (MDPI). 2024 Nov 17;7(4):101. doi: 10.3390/reports7040101.
Guyon's canal syndrome is a pathological condition caused by compression of the ulnar nerve at the level of the wrist. It is less frequent than other compression syndromes of the upper limb (cubital and carpal tunnel), and different causative agents, including vascular lesions, are described. Among these, aneurysm of the ulnar artery is described in the literature as an infrequent aetiology. We report the case of a 25-year-old young man with Guyon's canal syndrome caused by an aneurysm of the ulnar artery, who underwent surgical decompression of the Guyon's canal without intervening on the aneurysm. The postoperative course was free of complications, and the patient reported satisfaction, with reduced symptoms. Clinical examination and ultrasound imaging showed mass reduction of the aneurysm in the postoperative period, which appears to be an evolution hitherto undocumented in the literature. Many treatments are available for Guyon's canal syndrome. Past medical and surgical treatments, duration and severity of symptoms, causes, and pathogenesis are important for therapeutic choice. Surgical treatment based on ligament section and lysis of the Guyon's canal downstream, without any action on the aneurysm and with ulnar artery preservation, determined a reduction in terms of volume, relief of the symptoms, and patient satisfaction. With this case we describe a surgical therapeutic option for the treatment of Guyon's canal syndrome caused by an aneurysm of the ulnar artery, in which surgery is limited to canal decompression and consequential aneurysm mass reduction with concomitant relief of symptoms.
盖氏管综合征是一种由腕部尺神经受压引起的病理状况。它比上肢其他压迫综合征（肘管综合征和腕管综合征）少见，且有多种致病因素，包括血管病变。其中，尺动脉动脉瘤在文献中被描述为一种罕见病因。我们报告一例25岁青年男性因尺动脉动脉瘤导致盖氏管综合征，该患者接受了盖氏管手术减压，未对动脉瘤进行干预。术后过程无并发症，患者表示满意，症状减轻。临床检查和超声成像显示术后动脉瘤体积减小，这似乎是一种迄今文献中未记载的演变情况。对于盖氏管综合征有多种治疗方法。既往的药物和手术治疗、症状的持续时间和严重程度、病因及发病机制对治疗选择很重要。基于切开韧带并松解盖氏管下游，不对动脉瘤采取任何措施且保留尺动脉的手术治疗，使动脉瘤体积减小、症状缓解且患者满意。通过该病例，我们描述了一种治疗由尺动脉动脉瘤引起的盖氏管综合征的手术治疗方案，即手术仅限于管腔减压，随之动脉瘤体积减小并伴有症状缓解。
