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DOI: 10.1055/s-0037-1608683
An Aberrant Abductor Digiti Minimi Muscle Crossing Guyon's Canal with Intermittent Compression of Nerve: Crucial Diagnostic Role of Nerve and Muscle Ultrasound
Publication History
05 September 2017
28 September 2017
Publication Date:
05 January 2018 (online)

We read with interest your anatomical study “An aberrant abductor digiti minimi muscle crossing Guyon's canal” published in the Journal of Wrist Surgery 2017,[1] in which you demonstrated the presence of the aberrant abductor digiti minimi (AADM) muscle as a cause of compression of the ulnar nerve at Guyon's canal. In 2015, we published an article on muscle and nerve[2] in which an AADM was demonstrated bilaterally by using the ultrasonography (US) followed by a magnetic resonance imaging which confirmed the US diagnosis. The history of the patient was suggestive: he complains pain, grip weakness, and intermittent paresthesia on the three medial digits related to repetitive and heavy activity and the neurophysiological study fails to demonstrate ulnar nerve sensory and motor conduction velocity and amplitude deficits. The patient was operated on the symptomatic right side, and the AADM muscle was showed confirming the previously performed US. Surgery consisted of the simply AADM muscle resection and ulnar nerve decompression from the wrist to the palm ([Figs. 1] and [2]).




By this experience, we strongly suggest performing US (static and dynamic) in a patient with paresthesia and pain in which the neurophysiological study is negative.
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References
- 1 Nam Y, Hwang S, Eo S. An aberrant abductor digiti minimi muscle crossing Guyon's canal. J Wrist Surg 2017; 6 (03) 235-237
- 2 Coraci D, Luchetti R, Paolasso I, Santilli V, Padua L. Intermittent ulnar nerve compression due to accessory abductor digiti minimi muscle: Crucial diagnostic role of nerve ultrasound. Muscle Nerve 2015; 52 (03) 463-464