Bilateral median nerve compression at the level of Struthers' ligament

Abstract

Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.

Magnetic resonance imaging of the elbow

“…A small percentage of the population has a supracondylar process, a small bony spur arising from the anteromedial aspect of the distal humerus, approximately 5 cm above the medial epicondyle. A fibrous band called the ligament of Struthers passes between the supracondylar process and medial humeral epicondyle, and the nerve can be compressed as it passes through the foramen formed by this fibrous band (73,74). The median nerve may be compressed by a thickened bicipital aponeurosis or an accessory fibrous band associated with an anomalous third head of the biceps muscle (75).…”

Supracondylar and infratubercular processes observed in the humeri of Nigerians

“…It has been referred to as the "supraepithrochlear", "supracondyloid" "epicondyloid" or "supracondylar" process by various authors. It is a normal anatomical structure in climbing animals (Aydinlioglu et al, 2000). In human, it is a rare, anomalous, beak-like bony process on the anteromedial surface *Corresponding author: E-mail: kayodedanatomist@yahoo.com, Tel.…”

Morphological Study of the Supracondylar Process of the Humerus and Its Clinical Implications

“…The median nerve and/or brachial artery may become compressed causing clinical symptoms. Struthers [3], Solieri [4], and Aydinlioglu et al, [5] have described cases of median nerve entrapment. Compression and claudication of brachial artery has been reported by Hafid et al, [6] and Thompson and Edwards [7].…”

“…Terry [12] reported finding a supracondyloid process in 6 of 515 (1.16%) whites, but only once in 1,000 (0.1%) Negroes. It is a normal anatomical structure in climbing animals [5]. It represents the embryologic vestigial remnant of climbing animals and is seen in many reptiles, most marsupials, cats, lemurs and American monkeys [13].…”