open access

Vol 81, No 1 (2022)
Original article
Submitted: 2020-08-27
Accepted: 2020-11-01
Published online: 2020-12-30
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The ulnar nerve in the cubital tunnel: a foetal study

D. N. Bailey1, S. Ishwarkumar2, B. Z. De Gama1, P. Pillay1
DOI: 10.5603/FM.a2020.0150
·
Pubmed: 33438188
·
Folia Morphol 2022;81(1):31-36.
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
  2. Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, South Africa

open access

Vol 81, No 1 (2022)
ORIGINAL ARTICLES
Submitted: 2020-08-27
Accepted: 2020-11-01
Published online: 2020-12-30

Abstract

Background: 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. Then, it exits 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.
Materials and methods: This foetal study documented the course of the UN within the cubital tunnel and its anatomical relations utilising bilateral microscopic dissection of 25 foetuses (gestational age: 19–36 weeks).
Results: 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 was posteriorly related to the UN in 32% (16/50) of specimens. The Osborne’s 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 was present in 2% (1/50) of specimens.
Conclusions: 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

Background: 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. Then, it exits 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.
Materials and methods: This foetal study documented the course of the UN within the cubital tunnel and its anatomical relations utilising bilateral microscopic dissection of 25 foetuses (gestational age: 19–36 weeks).
Results: 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 was posteriorly related to the UN in 32% (16/50) of specimens. The Osborne’s 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 was present in 2% (1/50) of specimens.
Conclusions: 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, foetal study and anatomical course

About this article
Title

The ulnar nerve in the cubital tunnel: a foetal study

Journal

Folia Morphologica

Issue

Vol 81, No 1 (2022)

Article type

Original article

Pages

31-36

Published online

2020-12-30

Page views

2128

Article views/downloads

717

DOI

10.5603/FM.a2020.0150

Pubmed

33438188

Bibliographic record

Folia Morphol 2022;81(1):31-36.

Keywords

ulnar nerve
cubital fossa
foetal study and anatomical course

Authors

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

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