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Upper Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo
The presence of epitrochleoanconeus can lead to ulnar compression neuropathy at the elbow (Masear et al. 1988). Wilson et al. (2016) suggest that the presence of this muscle may protect against the development of cubital tunnel syndrome, as it may decrease the rigidity of the entrance into the cubital tunnel, replacing Osborne’s ligament as the roof of this tunnel.
Compression Neuropathies
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
The cubital tunnel syndrome is a slack region with restricted mobility of the ulnar nerve [22]. The ulnar nerve passes posterior to the medial epicondyle and medial to the olecranon. The cubital tunnel is a taut fascial layer extending from the flexor carpi ulnaris muscle and the arcuate ligament of Osborne. The ulnar nerve passes through the tunnel and enters the forearm between the ulnar and humeral heads of the flexor carpi ulnaris [23]. The superficial position of the ulnar nerve in the cubital tunnel and increase in tension and traction during the elbow flexion cause the ulnar nerve to be susceptible to compression neuropathy. Also, the cubital tunnel area is decreased in elbow flexion thereby increasing the intracanal pressure in the cubital tunnel. A 55% decrease in the cubital tunnel area and increase in pressure within the cubital tunnel is seen in elbow flexion with wrist extension or shoulder abduction (or with both) [24,25]. The common sites for ulnar nerve compression in the arm, elbow and forearm are:The arcade of StruthersThe intermuscular septumThe flexor carpi ulnaris fasciaThe anconeus epitrochlearisThe Osborne ligamentFascial bands within the flexor carpi ulnaris distally
The external elbow measure as surrogate of the anatomical width of cubital groove and possible risk factor of ulnar neuropathy at the elbow
Published in International Journal of Neuroscience, 2020
Mauro Mondelli, Claudia Vinciguerra, Stefano Lazzeretti, Palma Ciaramitaro, Francesco Sicurelli, Giuseppe Greco, Stefano Giorgi, Alessandro Aretini
During the flexo-extension movements of the elbow the ulnar nerve is at risk of damage because subjected to traction, compression and friction forces. If WCG is anatomically small, the probability of ulnar nerve damage may increase. We demonstrated that a short WCG is potentially risk factors of UNE. Many studies were published on US of the ulnar nerve in UNE [40,42–44], but no authors designed expressly a study to identify the relationship between the ulnar nerve and the anatomical dimensions of the site where the nerve runs at elbow in UNE subjects and controls. Further dynamic US studies may be useful to confirm our findings. Because we measured CGW only with elbow flexed at 90°, further dynamic US studies are necessary because CGW modifies according to flexion degree of the elbow like ulnar nerve dimension and the depth of the groove is impossible to measure with caliper. Therefore, the differences of CGW between cases and controls may be different based on the degree of elbow flexion and the risk may change. In addition, WCG may have a different weight as a risk factor according to the location of UNE; different therapeutic approaches were recently proposed: surgical release for ulnar nerve entrapment at Osborne ligament and conservative treatment for external nerve compression at retroepicondylar groove [41]. Finally, we will study relations between narrower WCG, lifestyle and occupational factors, especially related to non-neutral elbow postures, in a larger UNE sample.
Effect of dry needling on cubital tunnel syndrome: Three case reports
Published in Physiotherapy Theory and Practice, 2019
Sudarshan Anandkumar, Murugavel Manivasagam
The cubital tunnel is an anatomical space containing the ulnar nerve and ulnar collateral artery and extends from the medial epicondyle of the humerus to the olecranon process of the ulna (Shen, Masih, Patel, and Matcuk, 2016). The floor is formed by the joint capsule and medial collateral ligament of the elbow and the roof is formed by Osborne’s ligament (also known as cubital tunnel retinaculum), a fibrous band running between the two heads of flexor carpi ulnaris (FCU) (Green and Rayan, 1999). After the ulnar nerve exits the cubital tunnel, it penetrates between the ulnar and humeral heads of the FCU and passes through the flexor–pronator aponeurosis (which forms the common origin of the flexor and pronator muscles) (Amadio and Beckenbaugh, 1986). Multiple sites of ulnar nerve entrapment around the elbow have been described in the literature and include the Arcade of Struthers (about 8 cm proximal to the medial epicondyle), medial intermuscular septum, medial epicondyle (with osteophytes irritating the nerve), cubital tunnel, and deep flexor aponeurosis of the FCU (5 cm distal to the medial epicondyle) (Kroonen, 2012) (Figure 1).
Quality of life and satisfaction in patients surgically treated for cubital tunnel syndrome
Published in Neurological Research, 2023
María Elena Córdoba-Mosqueda, Lukas Rasulić, Andrija Savić, Jovan Grujić, Filip Vitošević, Milan Lepić, Aleksa Mićić, Stefan Radojević, Stefan Mandić-Rajčević, Ivana Jovanović, Carlos Alberto Rodríguez-Aceves
Decompression of the ulnar nerve was performed under local anesthesia on an in- or outpatient basis. The incision was made anterior to the medial condyle (Figure 2-A). The ulnar nerve was identified proximally (Figure 2-B) to the sulcus and dissected 5 cm distally toward the condyle (Figure 2-C). To achieve this, the Osborne ligament was divided. If the arcade of Struthers was found, it was also released (Figure 2-D). The ulnar nerve was explored between the two heads of the flexor carpi ulnaris muscle and the submuscular membranes (Figure 2-E); and other constrictive tissues around the nerve were released (Figure 2-F)[10]