Supracondylar process of the humerus: A rare case with compression of the ulnar nerve

Tzaveas, Alexandros; Dimitriadis, Anastasios G.; Αντωνίου, Κωνσταντίνος; Pazis, Ioannis G.; Paraskevas, Georgios; Vrettakos, Aristidis N.

doi:10.3109/02844310903123320

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…This bony prominence may be appreciated by clinicians and surgeons, as it can cause brachial artery, median nerve, ulnar artery or ulnar nerve compression thus causing neuropathies or vaso occlusive diseases (Thompson & Edwards;Tzaveas et al, 2010;Bain et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Supracondylar Process of the Humerus with Clinical and Surgical Applications to Orthopedics

Martin-Schütz¹,

Arcoverde²,

Barros³

et al. 2019

Int. J. Morphol.

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The supracondylar process is a hook shaped projection of the humerus. It is located superior to its medial epicondyle. This anatomic variation is often presented together with the Struther's ligament, a fibrous arcade that connects the supracondylar process to the medial epicondyle. Both structures have been associated with neurovascular bundle compression on the distal third of the arm, as the median and ulnar nerves and the brachial and ulnar arteries may pass through the osteofibrous canal that these variants create. The SciElo, Pubmed, Scopus, TRIP, MEDLINE, COCHRANE and ScienceDirect databases were searched with the term "supracondylar process" or "supracondyloid process" with the purpose of performing a meta-analysis of this bony spur. Heterogeneity between studies was evaluated using I2 estimation and the Cochran Q statistic test. A random effect model was used for all analysis. A total of twenty articles (26.415 humeri) were included in this meta-analysis. The pooled prevalence of the supracondylar process was 0.68 % (95 % Confidence Interval: 0.47 % to 0.92 %). This variant was more commonly found in women than in men (statistically significant difference) and more commonly found on the left side than the right. The presence of the supracondylar process alone may induce neurovascular bundle compression. It can also be injured in traumatic or stress fractures. Knowledge of this variation and its prevalence may reduce misdiagnosis in radiographic images.

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Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of the Supracondylar Process of the Humerus with Clinical and Surgical Applications to Orthopedics

Martin-Schütz¹,

Arcoverde²,

Barros³

et al. 2019

Int. J. Morphol.

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“…Six studies 47–52 describe 6 patients (3 males, 3 females, mean age 41.7 years) with various structures compressing the ulnar nerve. These structures include an aberrant triceps brachii slip, 48 flexor digiti minimi brevis muscle, 47 anconeus epimedialis muscle, 49 constriction band, 51 a hypermobile pisiform bone, 52 and supracondylar process 50 . All 6 patients underwent surgical decompression of the ulnar nerve resulting in either partial or complete remission of symptoms.…”

Section: Resultsmentioning

confidence: 99%

“…These structures include an aberrant triceps brachii slip, 48 flexor digiti minimi brevis muscle, 47 anconeus epimedialis muscle, 49 constriction band, 51 a hypermobile pisiform bone, 52 and supracondylar process. 50 All 6 patients underwent surgical decompression of the ulnar nerve resulting in either partial or complete remission of symptoms.…”

Section: Singular Casesmentioning

confidence: 99%

Uncommon Anatomical Causes of Ulnar Compression

Natroshvili,

Roorda,

van Doorn

et al. 2024

Ann Plast Surg

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Objectives Some patients develop ulnar nerve compression due to rare anatomical variations or malformations. The aims of this review are to provide a comprehensive overview of anatomical structures and variations that can cause ulnar nerve compression and to evaluate treatment options. Methods Case reports and case series about rare cases of unusual ulnar nerve compression published from January 2000 until April 2022 were obtained from databases Embase, MEDLINE, and Web of Science. A total of 48 studies describing 64 patients were included in our study. Results The following structures have proven to cause ulnar nerve compression: anconeus epitrochlearis, accessory abductor digiti minimi, vascular anomalies, palmaris longus, fibrous bands, and flexor carpi ulnaris. All cases except one have had a surgical release of the ulnar nerve resulting in diminished symptoms or complete recovery at follow-up. Conclusions In addition to considering common compression points, it is important to be aware that proximal compression symptoms, such as pain and a positive Tinel sign at the medial elbow, may be attributed to a hypertrophic AE or vascular anomaly. Distal compression symptoms encompass swelling, along with pain and a positive Tinel sign at the distal forearm. Various structures contributing to distal compression include an accessory abductor digiti minimi muscle, an accessory or anomalous palmaris longus muscle, or an accessory or hypertrophic flexor carpi ulnaris muscle. The occurrence of fibrous bands exhibits variability, manifesting in diverse locations across the arm. Level of Evidence: IV

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“…There is no agreement on the best angle for visualizing the SP. Tzaveas et al (2010) advise that the distal third of the arm should be taken in anteroposterior position with minimal internal arm rotation, as it is a more reliable angle than the oblique or pure anteroposterior angle. In contrast, Opanova and Atkinson (2014) and Ivins (1996) claim that visualization in the oblique position provides the most reliable outcomes.…”

Section: Supracondylar Processmentioning

confidence: 99%

“…The UN can be compressed directly either by the spur or by overgrown fibrous tissue. The chief complaint is pain that does not fade away during rest and which is especially exacerbated by full extension around the elbow joint, though in some individuals, significant pronation or flexion were the main symptom triggers (Kessel & Rang, 1966; Subasi et al, 2002; Thomsen, 1977; Tzaveas et al, 2010). However, the SP is reported as a possible cause of UN compression, either alone or together with the median nerve (Thomsen, 1977).…”

Section: Elbowmentioning

confidence: 99%

Possible points of compression of the ulnar nerve: Tricks and traps that await clinicians from an anatomical point of view

et al. 2021

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The ulnar nerve can be subject to numerous types of compression. The most common are cubital tunnel and ulnar tunnel syndromes, but there are many others with more uncommon etiologies. The existence of additional communicating branches, median nerve involvement, various types of injuries, and unusual anatomical variations can be a challenge for both diagnosis and treatment. This review presents a comprehensive depiction of ulnar nerve entrapment syndromes with particular reference to their anatomical background, risk factors, and clinical evaluation. Even common disorders can result from atypical morphological changes. It is important to be familiar with them as it is a key ability in daily medical practice.

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Supracondylar process of the humerus: A rare case with compression of the ulnar nerve

Abstract: A patient presented with a 6-month history of numbness and pain in the left forearm and hand over the ulnar nerve distribution. Radiographs showed a supracondylar process, which was excised. The ulnar nerve had been compressed. The patient was symptom-free two months postoperatively.

Cited by 7 publications

References 8 publications

A Meta-Analysis of the Supracondylar Process of the Humerus with Clinical and Surgical Applications to Orthopedics

A Meta-Analysis of the Supracondylar Process of the Humerus with Clinical and Surgical Applications to Orthopedics

Uncommon Anatomical Causes of Ulnar Compression

Possible points of compression of the ulnar nerve: Tricks and traps that await clinicians from an anatomical point of view

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