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Original article
Published online: 2020-12-30
Submitted: 2020-08-27
Accepted: 2020-11-01
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The ulnar nerve in the cubital tunnel: a fetal study

D. N. Bailey1, S. Ishwarkumar2, B. Z. De Gama1, P. Pillay1
DOI: 10.5603/FM.a2020.0150
·
Pubmed: 33438188
Affiliations
  1. Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa, South Africa
  2. Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, Gauteng, South Africa, South Africa

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2020-12-30
Submitted: 2020-08-27
Accepted: 2020-11-01

Abstract

The ulnar nerve (UN), a terminal branch of the medial cord of the brachial plexus, is located posteromedial to brachial artery coursing along medially in the arm from the anterior to the posterior compartment through the arcade of Struthers. It passes posterior to medial epicondyle of humerus and enters the cubital tunnel. Thereafter, exiting through the distal part of the cubital fossa to enter the medial side of the forearm between the two heads of the flexor carpi ulnaris muscle underneath Osborne’s ligament to enter the anterior compartment of the forearm. Entrapment of the UN at the cubital tunnel results in a pain and a tingling sensation on the medial side of the forearm and fourth and fifth digits. This fetal study documented the course of the UN within the cubital tunnel and its anatomical relationstwenty-five fetuses (gestational age between 19 – 36 weeks).

The UN followed the standard anatomical course in 96% (48/50) of the specimens, however it was found to lie deep to the muscles of the cubital tunnel in 6% (3/50). The radial artery joined the UN distal to the cubital tunnel in 8% (4/50), while the superior ulnar collateral artery (SUCA) was posteriorly related to the UN in 32% (16/50) of specimens. The Osborne ligament (crossed between the two heads of the flexor carpi ulnaris muscle, posterior to the medial epicondyle of the humerus) was present in all specimens 100% (50/50). It had a mean length of 6.32 ± 0.97 mm and 6.30 ± 1.10 mm on the left and right sides, respectively. The current study observed that the flexor pronator aponeurosis (FPA) was present in 2% (1/50) of specimens.

Knowledge of the normal and variable anatomical course of the UN in the cubital tunnel in this study may assist in the diagnosis and treatment of compressive neuropathy of the UN in the cubital tunnel.

Abstract

The ulnar nerve (UN), a terminal branch of the medial cord of the brachial plexus, is located posteromedial to brachial artery coursing along medially in the arm from the anterior to the posterior compartment through the arcade of Struthers. It passes posterior to medial epicondyle of humerus and enters the cubital tunnel. Thereafter, exiting through the distal part of the cubital fossa to enter the medial side of the forearm between the two heads of the flexor carpi ulnaris muscle underneath Osborne’s ligament to enter the anterior compartment of the forearm. Entrapment of the UN at the cubital tunnel results in a pain and a tingling sensation on the medial side of the forearm and fourth and fifth digits. This fetal study documented the course of the UN within the cubital tunnel and its anatomical relationstwenty-five fetuses (gestational age between 19 – 36 weeks).

The UN followed the standard anatomical course in 96% (48/50) of the specimens, however it was found to lie deep to the muscles of the cubital tunnel in 6% (3/50). The radial artery joined the UN distal to the cubital tunnel in 8% (4/50), while the superior ulnar collateral artery (SUCA) was posteriorly related to the UN in 32% (16/50) of specimens. The Osborne ligament (crossed between the two heads of the flexor carpi ulnaris muscle, posterior to the medial epicondyle of the humerus) was present in all specimens 100% (50/50). It had a mean length of 6.32 ± 0.97 mm and 6.30 ± 1.10 mm on the left and right sides, respectively. The current study observed that the flexor pronator aponeurosis (FPA) was present in 2% (1/50) of specimens.

Knowledge of the normal and variable anatomical course of the UN in the cubital tunnel in this study may assist in the diagnosis and treatment of compressive neuropathy of the UN in the cubital tunnel.

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Keywords

ulnar nerve, cubital fossa, fetal study and anatomical course

About this article
Title

The ulnar nerve in the cubital tunnel: a fetal study

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Original article

Published online

2020-12-30

DOI

10.5603/FM.a2020.0150

Pubmed

33438188

Keywords

ulnar nerve
cubital fossa
fetal study and anatomical course

Authors

D. N. Bailey
S. Ishwarkumar
B. Z. De Gama
P. Pillay

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