The ligament of Struthers was first described as a fibrous band extending from the supracondylar (supracondyloid) process or spur on the anteromedial aspect of the humerus downwards to the medial epicondyle [7] which occurs in <2% of humans. Several cases of median nerve entrapment have been attributed to the presence of ligament of Struthers.
Where is the ligament of Struthers located?
· Struthers' ligament is a feature of human anatomy consisting of a band of connective tissue at the medial aspect of the distal humerus. It courses from the supracondylar process of the humerus (also known as avian spur) to the medial humeral epicondyle. It is not a constant ligament, and can be acquired or congenital.
Is the ligament of Struthers complex associated with median nerve entrapment?
The ligament of Struthers was first described as a fibrous band extending from the supracondylar (supracondyloid) process or spur on the anteromedial aspect of the humerus downwards to the medial epicondyle [7] which occurs in <2% of humans. Several cases of median nerve entrapment have been attributed to the presence of ligament of Struthers.
What is Struthers'ligament?
· The Struthers’ ligament was described by anatomist John Struthers1 in 1854; it is a fibrous band that extends from a bone spur located on the anteromedial surface of the lower third of the humerus, known as the supracondylar process, and is inserted in the medial humeral epicondyle. The Struthers’ ligament passes over the median nerve and the brachial artery, …
Can ligament of Struthers complex cause neurovascular compression syndrome?
· This is the ligament of Struthers. It’s thought to be a vestigial third head of the coracobrachialis. It’s important because the spur and the ligament form a tunnel through which the median nerve and brachial artery pass, which can lead to compression. So clinically it may look like carpal tunnel but it’s really freaky bird-arm syndrome.
Where is the ligament of Struthers?
The Struthers' ligament was described by anatomist John Struthers1 in 1854; it is a fibrous band that extends from a bone spur located on the anteromedial surface of the lower third of the humerus, known as the supracondylar process, and is inserted in the medial humeral epicondyle.
Does everyone have a ligament of Struthers?
Prevalence. The ligament is not always present, and there is some debate as to its prevalence. Struthers originally estimated that it was present in 1% of humans.
How common is ligament of Struthers?
Its incidence was estimated by Struthers at 1%, but more recently has been estimated at 13.5%. Its clinical significance arises from the fact that the median nerve and brachial artery may pass through the "arch" formed by the process and ligament over the humeral body.
What is proximal attachment of the ligament of Struthers?
The Struthers' ligament (a) originated in the medial epicondyle (b) and moved proximally, fanning out and inserting into the brachial fascia and the internal brachial ligament and passing over the ulnar nerve (c) in precisely the place where the nerve passed from the anterior compartment to the posterior of the arm.
What is AIN palsy?
Anterior Interosseous nerve (AIN) syndrome is a rare syndrome that comprises less than 1% of all upper extremity nerve palsies, arising due to compression or inflammation of the AIN of the forearm. The AIN is purely a motor branch of the median nerve that arises from its dorsomedial aspect, just inferior to the elbow.
What is cubital fossa?
The cubital fossa is a small triangular area located on the anterior surface of the elbow, with the apex of the triangle pointing distally. It contains some important structures, on their passage from the arm to forearm. [[1] It is homologous to the popliteal fossa of the lower limb.
Where is the ligament of Treitz?
Where is the ligament of Treitz? The ligament of Treitz extends from the diaphragm to a part of the small intestine called the duodenojejunal flexure. The duodenojejunal flexure is a sharp angle in the small intestine between the duodenum and the jejunum (two parts of the small intestine).
What is flexor Retinaculum?
The flexor retinaculum is a fibrous connective tissue band that forms the anterior roof of the carpal tunnel. Many experts consider the flexor retinaculum synonymous with the transverse carpal ligament and the annular ligament; for this discussion, they will be considered the same structure.
What causes radial tunnel syndrome?
Most frequently, Radial Tunnel Syndrome occurs from compression in the proximal forearm associated with these muscles. Bone fractures, trauma to the soft tissues surrounding the nerve, or repetitive motion resulting in inflammation of the muscle can all result in Radial Tunnel Syndrome.
What is Anconeus Epitrochlearis?
The anconeus epitrochlearis is a muscle variant sometimes present at the elbow. It is present in up to 34% of individuals and has been implicated in some cases of cubital tunnel syndrome. We report an unusual variant of this muscle with additional proximal attachments in the arm.
What is the radial tunnel?
The radial tunnel is an area below your elbow. Your radial nerve enters this tunnel of muscle and bone and then travels down to your wrist. When your radial nerve is pinched anywhere in your arm, it can cause pain and weakness. The pinching is the result of some common daily activities.
Where does Brachioradialis attach?
styloid process of radiusBrachioradialis muscleOriginLateral supracondylar ridge of humerus, lateral intermuscular septum of armInsertion(Proximal to) styloid process of radiusActionElbow joint: Forearm flexion (when semi pronated)InnervationRadial nerve (C5-C6)Blood supplyRadial artery, radial recurrent arteries, radial collateral artery1 more row•May 11, 2020
Where is the ligament of Struthers located?
The ligament of Struthers most often arises from a supracondylar process, a bony projection at the anteromedial aspect of the distal humerus approximately 5 cm proximal to the medial epicondyle and extends to the medial epicondyle of the humerus.
What is supracondylar process?
The supracondylar process is an anatomic variant. It is a homologue of a similar bony projection seen in many amphibians, reptiles, and mammals. The ligament of Struthers is thought to be a vestige of the tendon of the latissimo-condyloideus muscle, found in some climbing animals.
Which nerve is susceptible to entrapment at the distal humerus?
Supracondylar process syndrome: The median nerve is susceptible to entrapment at the distal humerus in the presence of a fibrosseous tunnel formed by the humerus and the ligament of Struthers.
What?
Sometimes (like 1% of the time), your humerus has a weird extra spur sticking out of the distal metadiaphysis. This spur is referred to as a supracondylar spur, supracondylar process, supratrochlear spur, or “avian spur” more colloquially since your weird arm looks like some kind of bird arm or something.
Radiographic Appearance
Will see the spur pointing TOWARD the joint. Looks a lot like an osteochondroma, but those point away from the joint. I imagine you might be able to see the ligament itself on MRI, as well as signs of median nerve entrapment.
How am I supposed to remember this?
Sally Struthers was an actress in some show that was before my time. I only remember her for her correspondence school commercials where she was all, “do you want to make more money? Sure, we all do.” What that has to do with your weirdo bird-arm, I have no idea.
Will I ever see this?
Yes. Tim and/or Diego will come across one of these spurs while working on the bone list and ask you about it. The rookie mistake is to call it an osteochondroma, but as we know now, the avian spur points TOWARD the joint, while osteochondromas point away.
What is the arcade of Struthers?
The arcade of Struthers is a thin fibrous aponeurotic band extending from medial head of triceps to medial intermuscular septum situated approximately 6-10 cm proximal to medial epicondyle of the humerus. In most cases this structure is due to a thickening of brachial fascia 3 .
Who discovered the arcade of Struthers?
History and etymology. The arcade of Struthers was not actually documented by Sir John Struthers who described the ligament of Struthers. Later researchers found the structure, however, the discovery was not without controversy, with some groups claiming it did not exist 3,4 .
