ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 157-159 ◽  
Author(s):  
Piyapong Tiyaworanan ◽  
Surut Jianmongkol ◽  
Tala Thammaroj
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Study ◽  
Medial Epicondyle ◽  
Anatomical Location ◽  
Greater Tuberosity ◽  
Lateral Epicondyle ◽  
Surgical Exploration ◽  
Fresh Frozen ◽  
The Mean ◽  
Proximal Border

The incidence and the anatomical location of the arcade of Struthers as related to the arm length were studied in 62 arms of adult fresh-frozen cadavers. The distance between the greater tuberosity and the lateral epicondyle was designated as the arm length. The arcades of Struthers were identified in 85.4%. The mean arm length was 27.85 ± 1.3 cm. The mean of the distance between proximal border of the arcade of Struthers and the medial humeral epicondyle was 8.24 ± 2.06 cm. The mean ratio between the distance from the proximal border of the arcade to the tip of the medial epicondyle and arm length was 0.29 ± 0.07. We concluded that the anatomical location of the arcade as related to the arm length was 29% proximally, from the tip of the medial epicondyle. This report of the anatomical location of the arcade of Struthers related to the arm length can be useful to identify this structure in the arms which have differences in arm length during the surgical exploration and anterior transposition of the ulnar nerve procedures.

scholarly journals Practical ultrasonographic technique to precisely identify and differentiate tendons and ligaments of the elbow at the level of the humeral epicondyles: anatomical study

2020 ◽  
Author(s):  
Patrick Omoumi ◽  
Pedro Augusto Gondim Teixeira ◽  
Samuel R. Ward ◽  
Debbie Trudell ◽  
Donald Resnick
Keyword(s):  
Healthy Volunteers ◽  
Anatomical Study ◽  
Structure Identification ◽  
Layer By Layer ◽  
Accurate Identification ◽  
Lateral Epicondyle ◽  
Bony Landmarks ◽  
Fresh Frozen ◽  
Palmaris Longus Tendon ◽  
Dissection Technique

Abstract Objectives To develop a practical step-by-step technique to precisely identify and differentiate tendons and ligaments attaching to the humeral epicondyles, to confirm through gross anatomical study the accurate structure identification provided by this technique and to determine the frequency at which each structure can be identified in healthy volunteers. Materials and methods First, ten fresh frozen cadavers (6 men, age at death = 58–92 years) were examined by two musculoskeletal radiologists and a step-by-step technique for the identification of tendons and ligaments at the level of humeral epicondyles was developed. Second, the accurate identification of structures was confirmed through gross anatomical study including anatomical sections on five specimens and layer-by-layer dissection technique on five others. Finally, 12 healthy volunteers (6 men, average age = 36, range = 28–52) were scanned by two radiologists following the same technique. Results An ultrasonographic technique based on the recognition of bony landmarks and the use of ultrasonographic signs to differentiate overlapping structures was developed and validated through gross anatomical study. In healthy volunteers, most tendons and ligaments were identified and well-defined in ≥ 80% of cases, except for the extensor carpi radialis brevis and extensor digiti minimi tendons on the lateral epicondyle (having common attachments with the extensor digitorum communis) and the palmaris longus tendon on the medial epicondyle (absent, or common attachment with the flexor carpi radialis). Conclusion A step-by-step approach to the ultrasonographic assessment of tendons and ligaments at the humeral epicondyles allowed accurate identification of and differentiation among these structures, in particular those relevant to pathological conditions.

The effect of in-situ decompression on ulnar nerve stability: a cadaveric study

2017 ◽  
Vol 42 (7) ◽  
pp. 715-719 ◽  
Author(s):  
B. Butler ◽  
J. Peelman ◽  
L.-Q. Zhang ◽  
M. Kwasny ◽  
D. Nagle
Keyword(s):  
Ulnar Nerve ◽  
Medial Epicondyle ◽  
Cadaveric Study ◽  
Flexion Angle ◽  
Anterior Translation ◽  
Nerve Decompression ◽  
Flexor Carpi Ulnaris ◽  
Before And After ◽  
Fresh Frozen

Ten fresh frozen right cadaver arms were placed in a motorized jig and an in-situ ulnar nerve decompression was performed in 5 mm increments distally to the flexor carpi ulnaris (FCU) aponeurosis then proximally to the intermuscular septum. The elbows were ranged 0–135° after each incremental decompression and the ulnar nerve to medial epicodyle distance was measured to assess for nerve translation/subluxation compared with baseline (prerelease) values. None of the specimens had ulnar nerve subluxation (defined as anterior translation past the medial epicondyle) even after full decompression. Furthermore, there were no statistically significant ulnar nerve translations (defined as any difference in distance from ulnar nerve to medial epicondyle before and after each decompression) for any flexion angle or extent of decompression. This study provides biomechanical evidence that in situ ulnar nerve decompression from the FCU aponeurosis to the intermuscular septum does not result in significant ulnar nerve translation or subluxation.

scholarly journals The Anatomy of the Dorsal Capsulo-Scapholunate Septum: A Cadaveric Study

2017 ◽  
Vol 06 (03) ◽  
pp. 244-247 ◽  
Author(s):  
Marina Tommasini Carrara de Sambuy ◽  
Tanya Burgess ◽  
Christophe Mathoulin ◽  
Adeline Cambon-Binder
Keyword(s):  
Dorsal Surface ◽  
Anatomical Study ◽  
Biomechanical Properties ◽  
Scapholunate Ligament ◽  
Maximum Width ◽  
Interosseous Ligament ◽  
Gothic Architecture ◽  
Constant Structure ◽  
Fresh Frozen ◽  
The Mean

Background Tears of the dorsal radiocarpal capsule at the level of the scapholunate interosseous ligament (SLIL) have recently been described in association with predynamic scapholunate instability. Purpose The aim of this anatomical study of the dorsal capsulo-scapholunate septum (DCSS) was to examine the connection of the dorsal capsule on the SLIL and dorsal intercarpal ligament (DICL). Methods Fourteen fresh frozen wrists from seven adult cadavers were dissected through a dorsal approach. Any dorsal attachment of the DICL on the dorsal surface of the SLIL, that is, the DCSS, was identified and measured (height and width). Results The DCSS was consistently found connecting the DICL, the dorsal radiocarpal capsule, and the dorsal aspect of the SLIL. It was formed by the confluence of three arches like intersecting ribs in gothic architecture. The mean dimensions of the DCSS were 5.8 mm in height and 4.0 mm in maximum width. Conclusion The DCSS that connects the SLIL with the dorsal capsule and DICL could be a constant structure of dorsal wrist. Further investigation is required to study the histology of the DCSS and its biomechanical properties in isolation to know whether the DCSS can be considered a secondary stabilizer of the scapholunate ligament complex. Clinical Relevance A better anatomical knowledge of scapholunate ligament complex could help understand and manage instability of the wrist.

scholarly journals An anatomical study of medial epicondyle in relation with nerves

2021 ◽  
Vol 18 (2) ◽  
pp. 19-21
Author(s):  
Mangesh Santram Selukar ◽  
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Study ◽  
Cubital Tunnel Syndrome ◽  
Medial Epicondyle ◽  
Government Medical College ◽  
Branching Pattern ◽  
Microsoft Excel ◽  
Ulnar Nerve Compression ◽  
Medical College ◽  
Tunnel Syndrome

Background: Cubital tunnel syndrome, or ulnar nerve compression at the elbow, is the second most common compression neuropathy after carpal tunnel syndrome. Aims and Objectives: To study anatomy of the medial epicondyle in relation with nerves. Methodology: This was a cadaveric study in the 36 cadaveric hand dissected in the department of anatomy of V D Government Medical College, Latur during the two year duration i.e. January 2019 to January 2021, in the 2 years duration all the cadavers are dissected carefully and the observations were noted in the excel sheet. Data was entered in the Microsoft excel for windows 10 software and calculated Mean and Standard deviation. Result: In our study, Arm length (cm) was 28.12 ± 2.34; Length of Arcade of Struthers (AS) (cm) was 4.12 ± 1.65 Distance between AS and Medial epicondyle was 8.62 ± 0.98. Average branching pattern of nerve related to medial epicondyle i.e. for Median nerve branching (Mean ±SD) - 3.1 ± 0.94; Radial nerve branching (Mean ±SD) -2.28 ± 1.02; Ulnar nerve branching (Mean ±SD)- 2.91 ± 0.59 respectively. Conclusion: An anatomical study of medial epicondyle in relation with nerves not only important for the prevention of pathologies of elbow but also helpful in the treatment of the fractures of lower end of humerus and medical epicondyle.

Anatomy of the palmar branch of the ulnar nerve: application to ulnar and median nerve decompressive surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 263-267 ◽  
Author(s):  
R. Shane Tubbs ◽  
Jason M. Rogers ◽  
Marios Loukas ◽  
Ayhan Cömert ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Ulnar Artery ◽  
Medial Epicondyle ◽  
Palmar Arch ◽  
Medial Side ◽  
Fourth Digit ◽  
Palmar Cutaneous Branch ◽  
Cutaneous Branch ◽  
The Mean

Object The palmar cutaneous branch of the ulnar nerve (PCUN) has received little attention in the literature, and to the authors' knowledge, has received no attention in the neurosurgical literature. The present study was performed to help the surgeon minimize postoperative complications of nerve decompression at the wrist. Methods Forty cadaveric upper limbs underwent dissection of the ulnar nerve in the forearm, at the wrist, and in the palm. The PCUN was investigated and when identified, measurements were made and relationships documented between this cutaneous branch and the ulnar artery. The length and width of the PCUN were measured, as was the distance from the medial epicondyle of the humerus to the origin of the PCUN from the ulnar nerve. Results A PCUN was found on 90% of sides. The origin of the PCUN from the ulnar nerve was found to lay a mean of 14.3 cm distal to the medial epicondyle. The mean length and width of this branch were 13 and 0.08 cm, respectively. In the forearm, the PCUN traveled lateral to the ulnar artery on 75% of sides and on the medial side of this vessel on the remaining sides. The PCUN perforated the fascia of the anterior forearm just proximal to the distal wrist crease. In the palm, the PCUN traveled superficial to the superficial palmar arch on all but 5 sides, where it traveled deep to this vascular structure's distal extent. On 2 sides each, the PCUN communicated with the superficial and deep ulnar nerves. On 2 sides, the PCUN communicated with the palmar cutaneous branch of the median nerve. The majority of the terminal fibers of the PCUN were found on the ulnar side of a hypothetical line drawn longitudinally through the fourth digit and supplied an area roughly 3 × 3 cm over the proximal medial palm. Conclusions The authors hope that the present data may be useful to the surgeon during decompressive procedures at the wrist, such as carpal tunnel and the Guyon canal. Based on this study, skin incisions of the palm made longitudinally along a line through the middle of the fourth digit would minimize injury to the PCUN.

An Anatomical Study of Morton's Interdigital Neuroma: The Relationship Between the Occurring Site and the Deep Transverse Metatarsal Ligament (DTML)

2007 ◽  
Vol 28 (9) ◽  
pp. 1007-1010 ◽  
Author(s):  
J-Young Kim ◽  
Jae Hyuck Choi ◽  
Jungmin Park ◽  
Joonho Wang ◽  
Inmook Lee
Keyword(s):  
Anterior Margin ◽  
Metatarsophalangeal Joint ◽  
Anatomical Study ◽  
Causative Factor ◽  
Metatarsal Head ◽  
Digital Nerve ◽  
Fresh Frozen ◽  
The Common ◽  
The Mean ◽  
The Relationship

Background: Using clinical and cadaver studies, we examined the relationship between the location of Morton interdigital neuromas and the surrounding structures, including the deep transverse metatarsal ligament (DTML), which has been suspected as a major causative factor in neuroma formation. Methods: Seventeen fresh-frozen cadavers were evaluated to determine the relationship between the location of Morton interdigital neuromas and the DTML at two phases of the gait cycle with 60 degrees of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from the bifurcation of the common digital nerve in the foot to the anterior margin of the DTML and also measured the length of the DTML itself. Clinically, we checked the location of the Morton interdigital neuroma and its length during surgery in 32 feet. Results: In the second and third webspace, the mean distance from the bifurcation of the common digital nerve of the foot to the anterior margin of the DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm and 14.6 mm in the heel-off position. The length of the second and third DTML averaged 12.8 mm and 10.6 mm. Clinically, all of the cases of Morton interdigital neuroma started at the bifurcation area of the common digital nerve, and the mean neuroma length was 7.5 mm (6 to 11). Conclusions: Morton interdigital neuromas were located more distally than the DTML in both the mid-stance and the heel-off stage during walking. The main lesion was located between the metatarsal head and the metatarsophalangeal joint and more distal than the DTML, questioning previous studies suggesting that the DTML is the major causative factor in development of Morton interdigital neuroma.

scholarly journals The Incidence and Characteristics of Marinacci Anastomosis: An Anatomical Study

2020 ◽  
Vol 5 (03) ◽  
Author(s):  
Renata Hodzic ◽  
Mirsad Hodzic ◽  
Ermina Iljazovic ◽  
Nermina Piric ◽  
Sanela Zukic
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Hand Muscles ◽  
Time Period ◽  
Clinical Centre ◽  
Fresh Frozen ◽  
The Right ◽  
Anatomical Research

Marinacci anastomosis, also known as Ulnar-Median anastomosis, is an anastomosis in which the branch anastomotic originates proximally in the ulnar nerve and unites distally with the median nerve. A purpose of this study was to determine the incidence and  the characteristics of Marinacci anastomosis in the Bosnian population. The 60 anterior forearms of fresh frozen adult cadavers were dissected in the Department of Pathology,  University Clinical Centre Tuzla and the morgue of Tuzla during a time period of two years. The Marinacci anastomosis was evidenced in one male forearm in the right side behind the ulnar artery, following an transversal course of 5.2 cm until its connection with the median nerve in only one branch. The incidence of Marinacci anastomosis was 1.67%. Since this anastomosis can expalin some cases where injuries in the forearm nerves are not reflected in the hand muscles, it is important to study. Our study contributes to a limited research on the Marinacci anastomosis, a condition that is rarely found and reported in anatomical research.

The Anatomical Location of the Flexor Hallucis Brevis as It Pertains to Implant Arthroplasty

2012 ◽  
Vol 102 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Matthew DeMore ◽  
Erigena Baze ◽  
Anthony LaLama ◽  
Patrick Branagan ◽  
Michael Bowen ◽  
...  
Keyword(s):  
Articular Surface ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Anatomical Location ◽  
Foot And Ankle ◽  
Insertion Point ◽  
First Metatarsophalangeal Joint ◽  
Hallux Limitus ◽  
Fresh Frozen ◽  
The Mean

Background: Hallux limitus/rigidus is a painful arthritic condition affecting the first metatarsophalangeal joint that can be treated by implant arthroplasty, which, ultimately, may cause loss of the anatomical insertion points of the flexor hallucis brevis muscle. Preparation of the base involves resection of bone, thus compromising the insertion of the flexor hallucis brevis muscle. Methods: We dissected 54 fresh-frozen cadaveric specimens and quantitatively measured the distalmost insertion point of the medial and lateral heads of the flexor hallucis brevis muscle. These measurements were performed for both heads. The measurements were performed three times by three separate examiners. In addition, taking into consideration the anatomical construct of the articular surface of the base of the proximal phalanx of the hallux, another measurement was performed to note the concavity using 44 of the specimens. Again, these measurements were performed three times by three separate investigators. Results: The mean length from the base of the proximal phalanx to the distalmost insertion of the medial and lateral heads of the flexor hallucis brevis muscle was found to be 7 mm. Conclusions: This study provides precise anatomical data that can be used by foot and ankle surgeons when considering the use of implant arthroplasty for the treatment of hallux limitus/rigidus and the ability to maintain the insertion point of the flexor hallucis brevis muscle. (J Am Podiatr Med Assoc 102 (1):1-4, 2012)

scholarly journals Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

2015 ◽  
Vol 2015 ◽  
pp. 1-10
Author(s):  
Srinath Kamineni ◽  
Abdo Bachoura ◽  
Koichi Sasaki ◽  
Danielle Reilly ◽  
Kate N. Harris ◽  
...  
Keyword(s):  
Current Literature ◽  
Synovial Membrane ◽  
Distal Humerus ◽  
Medial Epicondyle ◽  
Medial Aspect ◽  
Lateral Epicondyle ◽  
Capsular Release ◽  
Working Space ◽  
The Mean ◽  
Gender Based

Introduction. The purpose of this study is to describe the inner synovial membrane (SM) of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL) was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%), an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

scholarly journals Open reduction and K-wires fixation of medial humeral epicondyle fractures with intra-articular elbow entrapment in children

2020 ◽  
Vol 8 (1) ◽  
pp. 73-82
Author(s):  
Daniele Massetti ◽  
Mario Marinelli ◽  
Valentino Coppa ◽  
Danya Falcioni ◽  
Nicola Specchia ◽  
...  
Keyword(s):  
Ulnar Nerve ◽  
Upper Limb ◽  
Open Reduction ◽  
Medial Epicondyle ◽  
Oral Antibiotic ◽  
Radiographic Outcomes ◽  
Elbow Fractures ◽  
Wire Fixation ◽  
The Mean ◽  
K Wires

Background. Medial epicondyle fracture (MEF) is a common injury of all elbow fractures in the pediatric and adolescent population and is often associated with elbow dislocation. Traditional management by cast immobilization increasingly is being replaced with early open reduction and K-wires or screws fixation. A consensus about the correct treatment of MEF is currently lacking in the medical literature. The aim of this study was to report the clinical and radiographic outcomes and the complications of patients affected from MEF with intra-articular fragment incarceration treated by open reduction and K-wire fixation. Materials and methods. Thirteen children (aged 813 years) with medial epicondyle fractures (MEF) with intra-articular elbow entrapment were retrospectively reviewed. All the enrolled patients were surgically treated with open reduction and k-wire fixation without exploration of ulnar nerve. Clinical outcomes were evaluated using upper limb alignment in the frontal plane, elbow range of motion (ROM), the Mayo Elbow Performance Score (MEPS) and with the Visual Analogue Scale (VAS). Radiographic outcomes and complications were also evaluated. Results. At a mean follow-up of 24.1 months no patients showed axial deformity of the upper limb or instability of the elbow and with preserved elbow ROM. The mean MEPS was 98.8 and the mean value of the VAS score was 1. The final X-rays showed fracture healing in 11 patients while 2 (15.3%) reported asymptomatic nonunion. Six patients of 13 presented with preoperative paresthesia in the ulnar nerve field but all of them reported a complete recovery after a mean of 4.3 months. All patients returned to their sporting activities at a mean of 5.4 months after surgery. One patient (7.7%) reported a superficial surgical wound infection treated with oral antibiotic medication without further surgery. No other complication was found. Conclusions. The results demonstrate that open reduction and K-wires fixation without exploration of ulnar nerve for MEF with intra-articular elbow entrapment treatment is a safe and effective procedure.

Sign in / Sign up

Export Citation Format

Share Document