Anconeus Epitrochlearis Muscle Associated With Cubital Tunnel Syndrome: A Case Series. Hand (N Y) 2019 Jul;14(4):477-482
Date
03/28/2018Pubmed ID
29582694Pubmed Central ID
PMC6760074DOI
10.1177/1558944718762566Scopus ID
2-s2.0-85044927960 (requires institutional sign-in at Scopus site) 10 CitationsAbstract
Background: Cubital tunnel syndrome is a common compressive neuropathy of the upper extremity. The anconeus epitrochlearis muscle is an unusual but occasional contributor. We review our experience with this anomalous muscle in elbows with cubital tunnel syndrome. Methods: We retrospectively reviewed charts of 13 patients noted to have an anconeus epitrochlearis muscle associated with cubital tunnel syndrome. Results: Ten patients had unilateral ulnar neuropathy supported by nerve conduction studies. Three had bilateral cubital tunnel syndrome symptoms with 1 of those having normal nerve conduction studies for both elbows. Eight elbows were treated with myotomy of the anconeus epitrochlearis muscle and submuscular transposition of the ulnar nerve. The other 8 elbows were treated with myotomy of the anconeus epitrochlearis muscle and in situ decompression of the ulnar nerve only. All but 1 patient had either clinical resolution or improvement of symptoms at follow-up ranging from 2 weeks to 1 year after surgery. The 1 patient who had persistent symptoms had received myotomy and in situ decompression of the ulnar nerve only. Conclusions: An anomalous anconeus epitrochlearis occasionally results in compression of the ulnar nerve but is usually an incidental finding. Its contribution to compression neuropathy can be tested intraoperatively by passively ranging the elbow while observing the change in vector and tension of its muscle fibers over the ulnar nerve. Regardless of findings, we recommend myotomy of the muscle and in situ decompression of the ulnar nerve. Submuscular transposition of the ulnar nerve may be necessary if there is subluxation.
Author List
Kim N, Stehr R, Matloub HS, Sanger JRAuthor
Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAftercare
Aged
Arthrogryposis
Cubital Tunnel Syndrome
Decompression, Surgical
Elbow Joint
Female
Hereditary Sensory and Motor Neuropathy
Humans
Male
Middle Aged
Muscle, Skeletal
Myotomy
Neural Conduction
Retrospective Studies
Treatment Outcome
Ulnar Nerve
Ulnar Neuropathies
