Guyon’s canal syndrome is ulnar nerve entrapment at the wrist and its presentation varies based on differential anatomy and the site or sites of compression (zones).

The causes of ulnar nerve compression include soft- tissue tumors; repetitive or acute trauma; the presence of anomalous muscles and fibrous bands; arthritic, synovial, endocrine, and metabolic conditions; and iatrogenic injury.

In addition to a thorough history and physical examination, which includes motor, sensory, and vascular assessments, imaging and nerve conduction studies facilitate the diagnosis of ulnar nerve lesions at the wrist.

Nonsurgical management is appropriate in early stages; however surgical decompression is indicated if symptoms persist or worsen over 2 to 4 months.

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