What is the role of the cubital tunnel in the etiology of ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

O’Driscoll suggested that the roof of the cubital tunnel (ie, the Osborne ligament or fascia), is a remnant of the anconeus epitrochlearis, [13] an aberrant muscle that has been found in 3-28% of cadaver elbows and in as many as 9% of patients undergoing surgery for cubital tunnel syndrome. This muscle arises from the medial humeral condyle and inserts on the olecranon, crossing superficially to the ulnar nerve, where it may cause compression. [14]

O’Driscoll also identified a retinaculum at the proximal edge of the arcuate ligament in all but 4 of 25 cadaveric specimens. [13] He classified this retinaculum into the following four types:

  • Absent retinaculum

  • Thin retinaculum that becomes tight with full flexion without compressing the nerve

  • Thick retinaculum that compresses the nerve between 90° and full flexion

  • Accessory anconeus epitrochlearis


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