Ulnar Tunnel Syndrome, Radial Tunnel Syndrome, Anterior Interosseous Nerve Syndrome, and Pronator Syndrome

J Am Acad Orthop Surg. 2017 Jan;25(1):e1-e10. doi: 10.5435/JAAOS-D-16-00010.


In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms. Spontaneous neuropathy of the anterior interosseous nerve of the median nerve can be observed without external compression. Electrodiagnostic and imaging studies may aid surgeons in the diagnosis of these syndromes; however, a thorough physical examination is paramount to localize compressed segments of these nerves. An understanding of the anatomy of each of these nerve areas allows practitioners to appreciate a patient's clinical findings and helps guide surgical decompression.

Publication types

  • Lecture

MeSH terms

  • Decompression, Surgical / methods
  • Forearm / innervation
  • Humans
  • Median Nerve / physiopathology
  • Median Neuropathy* / diagnosis
  • Median Neuropathy* / surgery
  • Nerve Compression Syndromes* / diagnosis
  • Nerve Compression Syndromes* / surgery
  • Physical Examination
  • Radial Neuropathy* / diagnosis
  • Radial Neuropathy* / surgery
  • Ulnar Nerve / physiopathology
  • Ulnar Nerve Compression Syndromes* / diagnosis
  • Ulnar Nerve Compression Syndromes* / surgery
  • Wrist / innervation