The supracondylar process, which was 11 mm in length and 6 cm above the medial epicondyle, was exposed through a medial approach ( Figure 2A). Surgery was performed under general anesthesia. A supracondylar process was found on X-ray images and computed tomography ( Figure 1A and and1B). A bony projection was felt at a site ~8 cm proximal to the medial epicondyle. Her ulnar nerve was normal without weakness or sensory abnormality, and normal muscle strength was observed in the flexor pollicis longus and flexor digitorum profundus. Physical examination revealed tenderness and a Tinel’s sign in the medial epicondyle. Because of pain, the patient had visited a private clinic and received injections several times without any benefit. Her symptoms were aggravated by continuous movement and local compression. 2, 3 We report 2 cases of supracondylar process for the first time in Korea, treated with surgical excision and decompression, and describe the diagnosis and treatment, along with the results of a literature review.Ī 36-year-old right-handed woman presented with pain in the medial aspect of the right elbow joint, which progressively worsened 3 months ago, with numbness in the distribution of the median nerve. Magnetic resonance imaging and ultrasound are also used for diagnosis. 6 The supracondylar process can be easily detected on X-ray images taken in oblique views but may not be identified if only anteroposterior or lateral views are taken. However, surgical decompression improved symptoms in most reports. 6 Symptomatic supracondylar process syndrome can be treated with a restriction of movement and conservative therapy, with relief of local compression. 4 The median nerve and brachial artery can be entrapped while passing through the deep layer of the tunnel formed by the supracondylar process and ligament of Struthers, and symptoms can manifest at the time of entrapment 5 or when the nerve passes the superficial layer and continues its course. 3 Without symptoms in most cases, supracondylar process syndrome can develop when neurovascular structures are compressed by the supracondylar process or ligament of Struthers. 2 It has been detected in 0.1%–2.7% of the healthy population and ranges from 2 to 20 mm in size as a distal projection.
1 The supracondylar process is a congenital bony protuberance on the anteromedial aspect of the distal humerus, ~5 cm proximal to the medial epicondyle. Struthers named the ligament of Struthers in 1854, describing it as a ligament or muscle fiber connecting the supracondylar process to the medial epicondyle.
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