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Osborne's ligament and the MCL
67%
3735/5580
MCL and Arcade of Struthers
6%
362/5580
Osborne's ligament and the intermuscular septum
14%
806/5580
MCL and medial head of the triceps
2%
85/5580
Ulnar and humeral heads of the flexor carpi ulnaris muscle
10%
553/5580
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The ulnar nerve passes posterior to the medial epicondyle and medial to the olecranon, then enters the cubital tunnel. The roof of the cubital tunnel is primarily made up of Osborne's ligament, and the floor consists of the medial collateral ligament. These soft tissue structures can cause narrowing of the tunnel, especially with elbow flexion, leading to ulnar nerve compression and cubital tunnel syndrome. This is shown in Illustration A. The Arcade of Struthers is a band of deep fascia that attaches to the intermuscular septum and covers the ulnar nerve 8 cm proximal to the medial epicondyle. The intramuscular septum is continuous from the medial epicondyle to the coracobrachialis muscle. The ulnar nerve travels through the two heads of the FCU distal to the cubital tunnel. These anatomic landmarks are shown in Illustration B. Morrey evaluated 26 patients with post-traumatic contracture of the elbow who were treated with either operative release alone, or operative release and distraction arthroplasty. Twenty-four (96%) of the patients had improved elbow function and two had persistent ulnar neuritis treated with nerve transposition. Cheung et al discuss the various surgical approaches to the elbow and the indications for each. Video V is an educational lecture that discusses common nerve entrapment diagnosis and managment.
3.6
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