Cubital Tunnel Syndrome Caused by Abnormal Insertion of Triceps Brachii Muscle

1994 ◽  
Vol 19 (1) ◽  
pp. 38-39 ◽  
Author(s):  
S. MATSUURA ◽  
T. KOJIMA ◽  
Y. KINOSHITA
Keyword(s):  
Clinical Course ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Triceps Brachii ◽  
Medial Head ◽  
Triceps Muscle ◽  
Triceps Brachii Muscle ◽  
Tunnel Syndrome ◽  
Operative Findings

Some cases of cubital tunnel syndrome are caused by anatomical abnormalities such as the epitrochleo-anconeus muscle or snapping and bulkiness of the medial head of the triceps brachii muscle. We report a rare cause of cubital tunnel syndrome that has not been reported previously. It was caused by an abnormal insertion of the medial head of the triceps muscle into the medial epicondyle. The clinical course and operative findings are described.

scholarly journals Ulnar Nerve Enlargement at the Medial Epicondyle Negatively Correlates With Nerve Conduction Velocity in Cubital Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 165-169
Author(s):  
T. David Luo ◽  
Amy P. Trammell ◽  
Luke P. Hedrick ◽  
Ethan R. Wiesler ◽  
Francis O. Walker ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Motor Nerve ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Motor Nerve Conduction ◽  
Nerve Enlargement ◽  
Tunnel Syndrome

Background: In cubital tunnel syndrome (CuTS), chronic compression often occurs at the origin of the flexor carpi ulnaris at the medial epicondyle. Motor nerve conduction velocity (NCV) across the elbow is assessed preoperatively to corroborate the clinical impression of CuTS. The purpose of this study was to correlate preoperative NCV to the direct measurements of ulnar nerve size about the elbow at the time of surgery in patients with clinical and/or electrodiagnostic evidence of CuTS. Methods: Data from 51 consecutive patients who underwent cubital tunnel release over a 2-year period were reviewed. Intraoperative measurements of the decompressed nerve were taken at 3 locations: at 4 cm proximal to the medial epicondyle, at the medial epicondyle, and at the distal aspect of Osborne fascia at the flexor aponeurotic origin. Correlation analysis was performed comparing nerve size measurements to slowing of ulnar motor nerve conduction velocities (NCV) below the normal threshold of 49 m/s across the elbow. Results: Enlargement of the ulnar nerve at the medial epicondyle and nerve compression at the flexor aponeurotic origin was a consistent finding. The mean calculated cross-sectional area of the ulnar nerve was 0.21 cm2 above the medial epicondyle, 0.30 cm2 at the medial epicondyle, and 0.20 cm2 at the flexor aponeurotic origin ( P < .001). There was an inverse correlation between change in nerve diameter and NCV slowing ( r = −0.529, P < .001). Conclusions: For patients with significantly reduced preoperative NCV and clinical findings of advanced ulnar neuropathy, surgeons can expect nerve enlargement, all of which may affect their surgical decision-making.

scholarly journals The 7 Structures Distal to the Elbow That Are Critical to Successful Anterior Transposition of the Ulnar Nerve

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 776-781 ◽  
Author(s):  
John M. Felder ◽  
Susan E. Mackinnon ◽  
Megan M. Patterson
Keyword(s):  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Anterior Transposition ◽  
Straight Line ◽  
Tunnel Syndrome ◽  
Poor Outcomes ◽  
Flexor Digitorum

Background: Ulnar nerve transposition (UNT) surgery is performed for the treatment of cubital tunnel syndrome. Improperly performed UNT can create iatrogenic pain and neuropathy. The aim of this study is to identify anatomical structures distal to the medial epicondyle that should be recognized by all surgeons performing UNT to prevent postoperative neuropathy. Methods: Ten cadaveric specimens were dissected with attention to the ulnar nerve. Intramuscular UNT surgery was simulated in each. Distal to the medial epicondyle, any anatomical structure prohibiting transposition of the ulnar nerve to a straight-line course across the flexor-pronator mass was noted and its distance from the medial epicondyle was measured. Results: Seven structures were found distal to the medial epicondyle whose recognition is critical to ensuring a successful anterior transposition of the ulnar nerve: (1) Branches of the medial antebrachial cutaneous (MABC) nerve; (2) Osborne’s fascia; (3) branches from the ulnar nerve to the flexor carpi ulnaris (FCU); (4) crossing vascular branches from the ulnar artery to the FCU; (5) the distal medial intermuscular septum between the FCU and flexor digitorum superficialis (FDS); (6) the combined muscular origins of the flexor-pronator muscles; and (7) the investing fascia of the FDS. Measurements are given for each structure. Conclusions: Poor outcomes and unnecessary revision surgeries for cubital tunnel syndrome can be avoided with intraoperative attention to 7 structures distal to the medial epicondyle. Surgeons should expect to dissect up to 12 cm distal to the medial epicondyle to adequately address these and prevent kinking of the nerve in transposition.

scholarly journals Cubital tunnel syndrome in Noonan syndrome secondary to hypoplasia of the humeral trochlea

2020 ◽  
Vol 8 ◽  
pp. 2050313X2093064
Author(s):  
Mana Koike ◽  
Tsuyoshi Tajika ◽  
Takuro Kuboi ◽  
Fumitaka Endo ◽  
Hirotaka Chikuda
Keyword(s):  
Noonan Syndrome ◽  
Cognitive Deficit ◽  
Autosomal Dominant ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Cubital Tunnel ◽  
Multisystem Disorder ◽  
Anatomical Features ◽  
Peripheral Compression ◽  
Tunnel Syndrome

This report describes the case of a 45-year-old woman with Noonan syndrome who developed cubital tunnel syndrome secondary to hypoplasia of the humeral trochlea. Cubital tunnel syndrome, the second-most common peripheral compression neuropathy, is caused by compression of the ulnar nerve at the elbow. Noonan syndrome, an autosomal dominant multisystem disorder, is characterized by variable cognitive deficit and skeletal, ectodermal and hematologic anomalies. Results show three distinctive anatomical features such as (1) hypoplasia of the humeral trochlea and medial epicondyle, (2) absence of the medial intermuscular septum and (3) lack of Osborn’s ligament.

scholarly journals Operative Findings in Reoperation of Patients with Cubital Tunnel Syndrome

Hand ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 137-143 ◽  
Author(s):  
Susan E. Mackinnon ◽  
Christine B. Novak
Keyword(s):  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cutaneous Nerve ◽  
Cubital Tunnel ◽  
Secondary Operation ◽  
Primary Surgery ◽  
Flexor Carpi Ulnaris ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Operative Findings

The purpose of this study was to report the operative findings in patients who underwent a secondary operation for cubital tunnel syndrome. A chart review was performed of 100 patients who had undergone a secondary operation for cubital tunnel syndrome by one surgeon. The mean age was 48 years (standard deviation 13.5 years). The most common complaint after primary surgery was increased symptoms in the ulnar nerve distribution ( n=55) and pain in the medial antebrachial cutaneous nerve distribution ( n=55). The most common operative findings included a medial antebrachial cutaneous nerve neuroma ( n=73) and a distal kink of the ulnar nerve ( n=57). This kink was noted as the nerve moved from its transposed position anterior to the medical epicondyle to its native position within the flexor carpi ulnaris. This study suggests that during primary surgery for cubital tunnel syndrome care should be given to avoid injury to the medial antebrachial cutaneous nerve, distal kinking of the ulnar nerve with transposition and pressure on the transposed nerve by the fascial flaps or tendinous bands.

ELBOW GANGLION ARISING FROM MEDIAL EPICONDYLE PSEUDARTHROSIS

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 155-158 ◽  
Author(s):  
Harvey Chim ◽  
Andrew K. T. Yam ◽  
Lam-Chuan Teoh
Keyword(s):  
Avulsion Fracture ◽  
Cubital Tunnel Syndrome ◽  
Joint Capsule ◽  
Medial Epicondyle ◽  
Differential Diagnoses ◽  
Cubital Tunnel ◽  
Medial Aspect ◽  
Non Union ◽  
Tunnel Syndrome

We present a patient with an asymptomatic painless medial elbow swelling of one year's duration, which was diagnosed as a ganglion originating from a non-united avulsion fracture of the medial epicondyle with a pseudarthrosis. Medial elbow ganglia are unusual lesions typically arising from the medial aspect of the ulnohumeral joint capsule, often in combination with symptoms of cubital tunnel syndrome. To our knowledge, a ganglion arising from a pseudarthrosis has not been reported in the literature, and should be considered in the differential diagnoses of lesions encountered over the site of fracture non-union in proximity to a joint.

A Case of Work-Related Cubital Tunnel Syndrome Due To Repetitive Motions

2000 ◽  
Vol 12 (2) ◽  
pp. 310
Author(s):  
Jung Won Kim ◽  
Insun Won Park ◽  
Youngjoon Won Lee ◽  
Yu Chang Kim ◽  
Pilja Chang Kim ◽  
...  
Keyword(s):  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Work Related ◽  
Tunnel Syndrome
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