Stress Fracture of the Supracondylar Process of the Humerus in a Professional Tennis Player

Pedret, Carles; Balius, Ramón; Alomar, Xavier; Vilaró, Jaume; Ruíz-Cotorro, Ángel; Minoves, M.

doi:10.1097/jsm.0000000000000101

Cited by 10 publications

(5 citation statements)

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“…This pathogenic entity is known as the supracondylar process syndrome [31]. Clinically, symptoms such as radiating or acute pain, complaints of sensory disturbances and reports of decreased grip strength are common in pathological cases [19,31,32]. During physical examination, vascular disturbances, sensory deficits, and decreased muscle strength, related to regions and structures innervated by the median nerve, can be observed.…”

Section: Discussionmentioning

confidence: 99%

“…The signs and symptoms will develop in accordance with the different variations of the regional anatomy, considering the anatomical characteristics of the supracondylar process, the course and thickness of the ligament, when present, and how soft structures pass through these elements. Diagnosis relies on physical examination and imaging tests, including oblique view radiographs of the forearm, computed tomography, and magnetic resonance imaging [32,33]. Electroneuromyography can be used to assess the severity of neurovascular compression [29].…”

Section: Discussionmentioning

confidence: 99%

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Case Report on a Supracondylar Process of the Humerus: Morphological and Morphometric analysis

Aragão,

Prado,

Sant’Anna Aragão

et al. 2024

BJCR

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The supracondylar process is a rare anatomical variation characterized by an irregular bone prominence with a variable size. Found in the anteromedial part of the distal region of the humerus, can compress the median nerve and other structures. The aim of this paper was to perform a morphological and morphometric evaluation of this variation in a right dry humerus. Faces, margins, and shape of the process were observed. Measurements was taken from the process and the entire bone. The apex of the process points toward the transition between the trochlea and the humeral capitulum. The bony spicule was 6.24 mm long. The base of the spicule measured 6.80 mm in length and 4.18 mm in width. Longitudinal crests associated with the base of the process and a deep longitudinal depression were observed. The combined longitudinal length of the caudal and cranial crests together was 32.37 mm. The distance from the bone spicule to the medial epicondyle was 65.29 mm. In pathological cases, vascular disturbances, sensory deficits, and decreased muscle strength can be observed. A comprehensive description of this variation is crucial for enhancing current knowledge and awareness in clinical practice, as it aids in accurate diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report on a Supracondylar Process of the Humerus: Morphological and Morphometric analysis

Aragão,

Prado,

Sant’Anna Aragão

et al. 2024

BJCR

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“…Fracture of the bone spur or concomitant compression of the ulnar nerve has been also described as a rare cause of pain in the presence of supracondylar process [ 3 ]. Pedret et al reported a case of a professional tennis player suffering from non-traumatic anteromedial arm pain and elbow stiffness [ 10 ]. The symptoms were attributed to stress fracture of the supracondylar humeral process after excessive traction of the pronator teres and the diagnosis was confirmed with x-rays and MRI.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Compression of the Neurovascular Bundle of Both Arms by a Bilateral Supracondylar Humeral Process: A Rare Case of Bilateral Nerve Entrapment of the Elbow in a Child

Chalidis¹,

Karagergou²,

Givissis³

2022

Cureus

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The supracondylar process is a beak-shaped bone spur arising from the anteromedial area of the distal humerus and in the majority of cases, it is connected to the medial epicondyle with a band of connective tissue which is known as ligament of Struthers. The complex of bone spur and ligament creates a ring that may compress the median nerve causing soreness and paresthesia of the hand and fingers. We present a rare case of bilateral supracondylar process compressing the neurovascular bundles in both arms and causing simultaneous bilateral upper limb pain, numbness, and weakness in an otherwise healthy young child. Surgical excision of the bone spurs and release of Struthers' ligaments provided immediate pain relief and complete resolution of symptoms. Three years after the index surgery, no limitations of activities or signs of recurrence were reported. Median nerve compression neuropathy in a child or a young adult should always raise the suspicion of the presence of supracondylar process particularly when bilateral symptoms exist. Although there are limited data about the incidence of recurrence and the extent of bone resection, the supracondylar process should be excised together with the overlying periosteum to minimize the theoretical risk of local regrowth.

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“…Pedret et al 25 apresentaram o caso de um tenista profissional, com fratura por estresse do processo supracondilar do úmero, que passou por cirurgia para evitar possíveis deslocamentos e complicações neurovasculares. Informam ser este o primeiro relato de uma fratura por estresse do processo supracondilar, acreditam que a tração excessiva do pronador redondo tenha sido o causador da fratura que foi visualizada tanto no exame radiográfico como na ressonância magnética.…”

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Arcada de Struthers versus ligamento de Struthers

Caetano

Neto

Vieira

et al. 2019

Rev. Fac. Ciênc. Méd. Sorocaba

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RESUMOObjetivo: Determinar a frequência e as características anatômicas da arcada de Struthers, do ligamento de Struthers e do processo supracondilar do úmero, bem como avaliar a implicação clínica dessas variações anatômicas na neuropatia compressiva dos nervos ulnar e mediano. Método: Dissecamos 60 membros superiores de cadáveres adultos pertencentes à Disciplina de Anatomia da Faculdade de Ciências Médicas e da Saúde da Pontifícia Universidade Católica de São Paulo (Campus Sorocaba), para realização deste trabalho. Em 40, estudamos a arcada de Struthers e em 20, apenas o ligamento de Struthers (60 membros no total). Resultados: Identificamos a arcada de Struthers nos 40 membros dissecados (100%). Em dois membros (5%), o nervo ulnar passava anteriormente à arcada. Em 29 (72,5%), uma porção variável do músculo tríceps cobria o nervo ulnar. Em 9 (22,5%), o nervo estava coberto pela expansão aponeurótica do tríceps. O processo supracondilar do úmero não foi encontrado em nenhum dos 60 braços dissecados. O ligamento de Struthers foi identificado em seis membros (dois bilaterais) -em todos havia inserção alta do músculo pronador redondo. Conclusão: A arcada de Struthers é um canal musculoaponeurótico que representa importante local potencial de compressão do nervo ulnar. O ligamento de Struthers é uma estrutura aponeurótica que pode, ou não, estar associada ao processo supracondilar do úmero e representa local potencial de compressão do nervo mediano no terço inferior do braço. ABSTRACT Objective:To determine the frequency and the anatomical features of the Struthers' arcade, Struthers ligament and supracondylar humeral process and to assess the clinical implication of these anatomical variations in ulnar and median nerve's compressive neuropathy. Method: We dissected 60 upper limbs of cadavers belonging to the Anatomy Discipline of the Faculty of measures and Health Sciences of the Catholic University of São Paulo (Campus Sorocaba) for this paper. In 40 limbs, the Struthers ligament and the Struthers Arcade were studied, and in only 20 the Struthers ligament (total 60 limbs). Results: We identified the Struthers arcade in the 40 dissected members (100%), and in two members (5%) the ulnar nerve previously passed the arcade. In 29 (72.5%) a variable portion of the triceps muscle was covering the ulnar nerve. In 9 members (22.5%) the nerve was covered by the aponeurotic expansion of the triceps. The supracondylar process of the humerus was not found in any of the 60 dissected arms. The Struthers ligament was identified in six members (two bilateral) and in all there was a high insertion of the pronator teres muscle. Conclusion: The Struthers arcade is a musculoaponeurotic channel that is a important site (potential) of ulnar nerve compression. The Struthers ligament is a aponeurotic structure that may or may not be associated with supracondylar humeral process, and represents a local potential median nerve compression in the lower third of the arm.

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Stress Fracture of the Supracondylar Process of the Humerus in a Professional Tennis Player

Cited by 10 publications

References 7 publications

Case Report on a Supracondylar Process of the Humerus: Morphological and Morphometric analysis

Case Report on a Supracondylar Process of the Humerus: Morphological and Morphometric analysis

Simultaneous Compression of the Neurovascular Bundle of Both Arms by a Bilateral Supracondylar Humeral Process: A Rare Case of Bilateral Nerve Entrapment of the Elbow in a Child

Arcada de Struthers versus ligamento de Struthers

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