Arcada de Struthers versus ligamento de Struthers

Edie Benedito Caetano; João José Sabongi Neto; Luiz Angelo Vieira; José Eduardo de Bona; Thais Mayor Simonatto

doi:10.23925/1984-4840.2019v21i1a3

Authors

Edie Benedito Caetano Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde (FCMS) – Sorocaba (SP), Brasil. http://orcid.org/0000-0003-4572-3854
João José Sabongi Neto Serviço de Cirurgia da Mão do Conjunto Hospitalar de Sorocaba (CHS) – Sorocaba (SP), Brasil. http://orcid.org/0000-0002-0554-1426
Luiz Angelo Vieira Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde (FCMS) – Sorocaba (SP), Brasil. http://orcid.org/0000-0003-4406-2492
José Eduardo de Bona Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde (FCMS) – Sorocaba (SP), Brasil. http://orcid.org/0000-0002-2416-7281
Thais Mayor Simonatto Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde (FCMS) – Sorocaba (SP), Brasil. http://orcid.org/0000-0002-0654-5373

DOI:

https://doi.org/10.23925/1984-4840.2019v21i1a3

Keywords:

nerve compression syndromes, median nerve, ulnar nerve, ligaments, arm, anatomic variation

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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Author Biography

Edie Benedito Caetano, Pontifícia Universidade Católica de São Paulo (PUC-SP), Faculdade de Ciências Médicas e da Saúde (FCMS) – Sorocaba (SP), Brasil.

Departamento de Cirurgia da Faculdade de Ciências Médicas e da Saúde PUC-SP

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