Infraclavicular Ulnar Nerve Entrapment Due to a Chondroepitrochlearis Muscle

Spinner, Robert J.; Carmichael, S. W.; Spinner, Morton

doi:10.1016/0266-7681(91)90060-2

Cited by 35 publications

(47 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Near its point of insertion, the tendinous fibers of the AcBr split to form a fork around the median nerve within the cubital fossa. This could lead to compression of the nerve, similar to the effects seen in an accessory head of the biceps brachii (Ozan, 1997), ulnar nerve entrapment by chondroepitrochlearis (Spinner et al, 1991), or median neuropathy because of brachialis tendon (Coonrad and Spinner, 1995). In this case, if the median nerve were to be entrapped by the AcBr, the symptoms might be similar to those described for carpal tunnel syndrome (Townsend et al, 2004), or pronator teres syndrome, as described in a case of an accessory tendon to the brachialis muscle by Flory and Berger (1985).…”

Section: Discussionmentioning

confidence: 91%

A case of an accessory brachialis muscle

et al. 2006

View full text Add to dashboard Cite

Functionally, the brachialis muscle serves a critical role as the primary flexor of the arm at the elbow. However, few reports exist in the literature, which describe variations of this muscle. We present a case of an accessory brachialis muscle (AcBr), found during routine dissection at Harvard Medical School during 2003. The AcBr originated medially from the mid-shaft of the humerus and the medial intermuscular septum. During its course medially, toward the elbow, the AcBr crossed both the brachial artery and the median nerve. The distal tendon split to surround the median nerve before inserting into the common tendon of the antebrachial flexor compartment muscles. Embryological origins and clinical considerations including median nerve entrapment are considered.

show abstract

Section: Discussionmentioning

confidence: 91%

A case of an accessory brachialis muscle

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The axillary arch and the chondroepitrochlearis muscle may appear as a visible axillary mass [15,19,26]. With regard to imaging modalities, a recent study [9] mentions that venography, mammography, axillary echograhy, computed tomography and magnetic resonance imaging have been used to detect the presence of the axillary arch only in sporadic clinical reports.…”

Section: Discussionmentioning

confidence: 99%

Abnormal muscles that may affect axillary lymphadenectomy: surgical anatomy

Natsis

Vlasis

Totlis

et al. 2009

Breast Cancer Res Treat

View full text Add to dashboard Cite

Purpose The present study aimed at summarizing and presenting the anomalous muscles that a surgeon might encounter during axillary lymphadenectomy (AL). Methods For this purpose, both the anatomical and surgical literature was reviewed and an anatomical study on 107 cadavers was carried out. Furthermore, based on the anatomical features of the anomalous muscles that came up during our study and taking into consideration the landmarks of the AL, we further analyzed the complications that may arise from each of these muscles, along with their preoperative and intraoperative recognition and management. Results The literature review revealed that there are three supernumerary muscles that may affect the AL, namely the Langer's axillary arch, the pectoralis quartus and the chondroepitrochlearis muscles, as well as the aplasia of the lower part of the pectoralis major muscle. Eight out of the 107 (7.48%) cadavers that we dissected had such an abnormal muscle in the axilla. Specifically, the axillary arch was found unilaterally in five cadavers (4.67%) and the pectoralis quartus muscle was present unilaterally in three cadavers (2.8%). One cadaver had both an axillary arch and a pectoralis quartus muscle in the right side. The abdominal and almost the whole sternocostal portion of the pectoralis major as well the pectoralis minor muscle were absent in one cadaver (0.93%). The chondroepitrochlearis muscle was not found in any of the cadavers that we dissected. Conclusions The present study offers the necessary preoperative knowledge for recognizing these muscles during AL, avoiding thus the complications that may arise from them.

show abstract

“…This is rather to be expected, because the DE muscle is located far posterior to the axillary neurovascular bundle, in contrast to the axillary arch which crosses with it. In cases of supernumerary muscles, if such symptoms are present, then surgical excision of the muscle decompresses the neurovascular bundle and relieves symptoms [8,9]. Apart from the absence of neurovascular compression in our case, surgical exploration of the muscle was avoided, because preoperative accurate diagnosis reassured the patient.…”

Section: Discussionmentioning

confidence: 64%