Supracondylar process syndrome: two cases of median nerve neuropathy due to compression by the ligament of Struthers

Hyun-Chul Shon, Ji-Kang Park, Dong-Soo Kim, Sang-Woo Kang, Kook-Jong Kim, Seok-Hyun Hong

Department of Orthopaedic Surgery, Chungbuk National University Hospital, Chungbuk National University, Cheongju, Korea

Abstract: The supracondylar process is a beak-shaped bony process on the anteromedial aspect of the distal humerus. The ligament of Struthers is a fibrous band extending from the tip of the process to the medial epicondyle. The median nerve and brachial artery pass under the ligament of Struthers and consequently can be compressed, causing supracondylar process syndrome. As a rare cause of proximal median nerve entrapment, supracondylar process syndrome is triggered when the median nerve is located in the superficial or deep layer of the ligament of Struthers as a result of anatomical variation. The supracondylar process can be easily detected on X-ray images obtained in oblique views but may not be identified in only anteroposterior or lateral views. In this article, we present 2 cases of supracondylar process syndrome and describe the process of diagnosis and treatment and results of a literature review.

Keywords: supracondylar process syndrome, ligament of Struthers, median nerve, nerve entrapment