Ultrasound-Guided Perineural Injection at Guyon's Tunnel: An Anatomic Feasibility Study.

Abstract

Compression of the ulnar nerve (UN) at the wrist causes neuropathy in the ulnar tunnel (UT), or Guyon's tunnel. In the absence of trauma and motor syndromes, primarily conservative treatment is considered. As in carpal tunnel syndrome, a perineural injection of corticosteroids may be beneficial. The aim of this study was to investigate the feasibility of ultrasound-guided injections at the UT. We performed ultrasound-guided injections of ink at the UN within the UT in 21 limbs from 11 non-embalmed cadavers. In all cases, we stained the perineural sheath of the superficial branch of the ulnar nerve within the UT. No ink was found inside the nerve or in adjacent structures such as blood vessels and tendons. In conclusion, perineural injection of the UN in the UT seems to be a technically feasible procedure. On the basis of these anatomic data, clinical trials are needed to prove the concept for routine use.

• Authors: Stefan Meng, Ines Tinhofer, Wolfgang Grisold, Wolfgang J Weninger
• Journal: Ultrasound in medicine & biology (Ultrasound Med Biol) Vol. 41 Issue 8 Pg. 2119-24 (Aug 2015) ISSN: 1879-291X [Electronic] England
• PMID: 25937521 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Cadaver
• Feasibility Studies
• Female
• Humans
• Injections (methods)
• Ink
• Male
• Tissue Distribution
• Ulnar Nerve (chemistry, diagnostic imaging)
• Ultrasonography, Interventional (methods)
• Wrist Joint (chemistry)