Handlebar palsy--a compression syndrome of the deep terminal (motor) branch of the ulnar nerve in biking |
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Authors: | Capitani Daniel Beer Serafin |
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Institution: | (1) Centre of Neurorehabilitation, Klinik Valens, 7317 Valens, Switzerland. s.beer@klinik-valens.ch, CH |
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Abstract: | We describe 3 patients who developed a severe palsy of the intrinsic ulnar supplied hand muscles after bicycle riding. Clinically
and electrophysiologically all showed an isolated lesion of the deep terminal motor branch of the ulnar nerve leaving the
hypothenar muscle and the distal sensory branch intact. This type of lesion at the canal of Guyon is quite unusual, caused
in the majority of cases by chronic external pressure over the ulnar palm. In earlier reports describing this lesion in bicycle
riders, most patients experienced this lesion after a long distance ride. Due to the change of riding position and shape of
handlebars (horn handle) in recent years, however, even a single bicycle ride may be sufficient to cause a lesion of this
ulnar branch. Especially in downhill riding, a large part of the body weight is supported by the hand on the corner of the
handlebar leading to a high load at Guyon's canal. As no sensory fibres are affected, the patients are not aware of the ongoing
nerve compression until a severe lesion develops. Individual adaptation of the handlebar and riding position seems to be crucial
for prevention of this type of nerve lesion.
Received: 7 January 2002, Received in revised form: 1 May 2002, Accepted: 7 May 2002
Correspondence to Dr. S. Beer |
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Keywords: | ulnar nerve external compression syndrome ulnar nerve entrapment at the wrist guyon syndrome bicycling |
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