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Canalicular neurological injuries

Introduction

Nerves are those anatomical structures ranging from the spinal cord to the muscles and other organs of the limbs.

They are organized in different anatomical structures depending on the location they occupy in the limb. At the root of the limbs, when them emerge from the spinal cord, nerves form plexus that are branched, forming trunks and terminal branches that will provide the innervation to the muscles.

This whole set of nerve fibers is called the peripheral nervous system. It conducts nerve impulses from the brain and spinal cord control centers (central nervous system)  forward to the muscles and backward from the muscles and sensitive receptors to the central nervous system.

To perform its function, nerves contain different types of fibers. Motor fibers that conduct orders from the brain or spinal cord to the muscles, sensory fibers that collect information from the periphery and transmit it to the central nervous system and autonomous fibers that regulate those organs which activity does not have voluntary control, for example the heart muscle.

During the embryonic period when the nerves are distributed from the center to the periphery, they settling between muscle structures around the joints.

With the passage of time due to small repeated trauma or overuse they are going to produce friction on these neural structures and ligaments, fascia and muscles that surround them, which can lead to nerve compression and entrapment.

During the embryonic period, nerves are distributed from the center to the periphery of the body, settling between muscles and around joints.

Over time, due to repeated minor trauma and normal joint activity, some friction is produced in the nerve structures by the bones, ligaments, fascias and muscles, and that situation can lead to nerve compression, this is what we know as canalicular syndromes.

 

Canalicular syndromes

The canalicular syndromes are a very common condition, especially in the upper extremity.

It is important to differentiate whether the cause is due to compressive or medical condition. If it is a pure mechanical compression treatment usually is a nerve decompression surgery. If a neurological or metabolic pathology is responsible for nerve injury (for example diabetes or hypothyroidism) the treatment should be directed to the control of the disease.

We emphasize a careful history and thorough physical examination. Some neuropathies may be hereditary and manifest in different degrees in the offspring. Knowing the medical history of the patient and family is necessary for a correct diagnostic approach in these cases.

In the case of pure mechanical compressions there are provocation maneuvers that reproduce symptomatology. Many times we must do neurohysiological tests, such as electromyography, or imaging tests to clarify the diagnosis.

It is also important to know that the same nerve compression may be a double level compression, in these cases a simultaneous decompression in the two locations is required.

Once we know that the cause is a mechanical compression, this is a surgical emergency, as if compression persists over time, it can cause irreversible nerve damage, leaving a loss of sensation and motor impairment that can lead to paralysis muscle and loss of function of the limb.

To know more:

Canalicular syndromes description

Canalicular syndromes. Treatment

Canalicular syndromes. FAQ

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