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Compression of the Ulnar Nerve by the Arcade of Struthers: Look and You Shall Find.
Elmaraghi, Shady; Taylor, Ruby; Tung, Isaac; Patterson, Megan M; Mackinnon, Susan E.
Affiliation
  • Elmaraghi S; Department of Plastic and Reconstructive Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA.
  • Taylor R; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
  • Tung I; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
  • Patterson MM; Department of Orthopedic Surgery, University of North Carolina, Chapel Hill, USA.
  • Mackinnon SE; Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Hand (N Y) ; : 15589447241232013, 2024 Feb 23.
Article in En | MEDLINE | ID: mdl-38390835
ABSTRACT

BACKGROUND:

The arcade of Struthers was first proposed by Kane et al in 1973. Clinical investigations of this structure have been limited to small case series, focusing on the arcade as an isolated cause of compressive ulnar neuropathy. The purpose of our study was to investigate the incidence of this structure in patients undergoing ulnar nerve transposition.

METHODS:

A retrospective chart review of prospectively maintained data in a single surgeon's practice was performed. Records of patients undergoing surgery for compressive ulnar neuropathy at the cubital tunnel were evaluated for documentation of a compressive arcade of Struthers. In addition, a scoping review of the literature was undertaken to better characterize current understanding of this structure and its recognition in clinical practice.

RESULTS:

A total of 197 patients underwent ulnar nerve transposition. The overall incidence of a compressive arcade of Struthers was noted to be 67 out of 197 (34%). All patients with a compressive arcade were noted to have an internal brachial ligament running below the nerve. Patients undergoing revision surgery were found to have a compressive arcade 51% of the time (20/39), whereas 30% of patients undergoing primary surgery were found to have a compressive arcade (47/158). Only 12 clinical studies examining the arcade of Struthers have been published in the last 20 years, the majority being single case reports.

CONCLUSIONS:

Compression of the ulnar nerve by the arcade of Struthers is a common finding and can contribute to compressive ulnar neuropathy at the elbow both in primary and revision cases.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Hand (N Y) Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Hand (N Y) Year: 2024 Document type: Article Affiliation country: United States Country of publication: United States