{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T10:13:20Z","timestamp":1758708800717},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Ulnar nerve mononeuropathy diagnosis can be challenging depending on where neural lesion is present. Repetitive trauma during cycling is a rare cause of ulnar neuropathy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>We describe two patients who developed the handlebar syndrome, an ulnar nerve palsy at Guyon\u2019s canal after cycling. The first patient had the syndrome after a short-distance ride and she was treated surgically, while the second patient developed the classical syndrome after a long ride and received conservative treatment. Surgical treatment of the first patient led to functional recovery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Handlebar syndrome is a neuropathy caused by extrinsic repetitive compression of ulnar nerve at wrist. Increasing incidence of this disease can be expected after increasing popularity of cycling sports. Avoid of repetitive trauma is the main management goal, with surgical treatment reserved for failure of conservative treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_606_2020","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T05:28:23Z","timestamp":1603949303000},"page":"366","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute handlebar syndrome: Two extremes of a challenging diagnosis"],"prefix":"10.25259","volume":"11","author":[{"given":"Fabio Veiga de Castro","family":"Sparapani","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Rua Napole\u00e3o de Barros, 720, 6th floor, Sao Paulo, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Universidade Federal de S\u00e3o Paulo, Rua Napole\u00e3o de Barros, 720, 1st floor, Sao Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo Favi","family":"Bocca","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Rua Napole\u00e3o de Barros, 720, 6th floor, Sao Paulo, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Renato","family":"Nakachima","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Universidade Federal de S\u00e3o Paulo, Rua Napole\u00e3o de Barros, 720, 1st floor, Sao Paulo, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Rua Napole\u00e3o de Barros, 720, 6th floor, Sao Paulo, Brazil,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2020,10,29]]},"reference":[{"key":"10.25259\/SNI_606_2020\/ref-1","first-page":"413","article-title":"Guyon canal syndrome: Lack of management in a case of unresolved handlebar palsy","volume":"58","author":"Brown","year":"2014","journal-title":"J Can Chiropr Assoc"},{"key":"10.25259\/SNI_606_2020\/ref-2","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s00415-002-0864-4","article-title":"Handlebar palsy-a compression syndrome of the deep terminal (motor) branch of the ulnar nerve in biking","volume":"249","author":"Capitani","year":"2002","journal-title":"J Neurol"},{"key":"10.25259\/SNI_606_2020\/ref-3","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1227\/00006123-198805000-00016","article-title":"Distal ulnar neuropathy from carpal ganglia: A clinical and electrophysiological study","volume":"22","author":"Cavallo","year":"1988","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_606_2020\/ref-4","first-page":"628","article-title":"Cycling injuries","volume":"39","author":"Cohen","year":"1993","journal-title":"Can Fam Physician"},{"key":"10.25259\/SNI_606_2020\/ref-5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2165\/00007256-200636010-00002","article-title":"Non-traumatic bicycle injuries: A review of the literature","volume":"36","author":"Dettori","year":"2006","journal-title":"Sports Med"},{"key":"10.25259\/SNI_606_2020\/ref-6","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1136\/bjsports-2013-092280","article-title":"How to treat guyon\u2019s canal syndrome? Results from the European handguide study: A multidisciplinary treatment guideline","volume":"47","author":"Hoogvliet","year":"2013","journal-title":"Br J Sports Med"},{"key":"10.25259\/SNI_606_2020\/ref-7","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/B978-0-12-802653-3.00082-8","article-title":"Peripheral nerve injury of the upper extremity","volume-title":"Nerves and Nerve Injuries","author":"Neal","year":"2015"},{"key":"10.25259\/SNI_606_2020\/ref-8","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.2106\/00004623-196951060-00004","article-title":"Ulnar-nerve compression syndromes at and below the wrist","volume":"51","author":"Shea","year":"1969","journal-title":"J Bone Joint Surg Am"},{"key":"10.25259\/SNI_606_2020\/ref-9","first-page":"341","article-title":"Peripheral nerve injuries in athletes","volume-title":"Handbook of Neurological Sports Medicine Concussion and Other Nervous System Injuries in the Athlete","author":"Sparapani","year":"2015"},{"key":"10.25259\/SNI_606_2020\/ref-10","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/0090-3019(85)90096-5","article-title":"Distal ulnar neuropathy. 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