The Supracondylar Process: A Rare Case of Ulnar Nerve Entrapment and Literature Review

Author:

May-Miller Peter1,Robinson Simon2,Sharma Prateek3,Shahane Shantanu4

Affiliation:

1. Department of General Surgery, Queen Alexandra Hospital Portsmouth, Portsmouth, United Kingdom

2. Department of Orthopaedic Surgery, Wirral University Teaching Hospital NHS Foundation Trust, Wirral, United Kingdom

3. Department of Radiology, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, United Kingdom

4. Department of Orthopaedic Surgery, Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, United Kingdom

Abstract

AbstractA fit and well 33-year-old male mechanic was referred to the clinic complaining of locking of right elbow and paraesthesia and pain affecting the forearm and hand. Radiographs demonstrated a right-sided supracondylar process. The patient had locking of his right elbow, which caused shooting pains both distally and proximally. The ulnar nerve was irritable proximal to the cubital tunnel, and there was some weakness of the ulnar nerve supplied muscles of the hand and forearm. The patient had a subjective feeling of altered sensation over the medial one and a half digits. The magnetic resonance imaging (MRI) suggested that there was anomalous anatomy around the elbow and that compression of the ulnar and or the median nerve by a fibrous band appeared to be the cause of his symptoms. A surgical exploration was arranged. The incision was posterior to the medial epicondyle. A fascial/muscular band was identified from the tip of the supratrochlear spur to the olecranon and was seen to kink the ulnar nerve. This was corrected upon its release. The supratrochlear spur was excised with an osteotome, and bone wax applied to the humerus. On review 6 weeks postoperatively, his function had returned to normal.

Funder

None

Publisher

Georg Thieme Verlag KG

Subject

Surgery

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