Anatomical Distribution of Branches of the Medial Antebrachial Cutaneous Nerve during Cubital Tunnel Surgery

Purpose: The purpose of this prospective study is to examine the anatomical variations of the branches of the medial antebrachial cutaneous nerve in Koreans encountered during cubital tunnel surgery. Methods: Ninety two patients with cubital tunnel syndrome were treated with a standard approach from December 2008 to July 2012. The position of the branches of medial antebrachial cutaneous nerve was evaluated based on the medial humeral epicondyle with the elbows fully extended. Results: At least one medial antebrachial cutaneous nerve branch was found during the surgeries in all patients. The average number of crossing medial antebrachial cutaneous nerve branches per patient was 1.6. Thirty-eight percent of the cases showed that the medial cutaneous nerve branches cross proximal to the medial humeral epicondyle within 1 cm. Eighty-two percent showed that the medial antebrachial cutaneous nerve branches cross distal to the medial humeral epicondyle within 1.9 cm. Conclusion: When using standard approach during cubital tunnel surgery, more than one medial forearm cutaneous nerve is found. Therefore, understanding the general position of medial antebrachial cutaneous nerve branches helps avoid iatrogenic damage to this nerve during cubital tunnel surgery.

[1]  M. Vogt,et al.  Medial brachial and antebrachial cutaneous nerve injuries: effect on outcome in revision cubital tunnel surgery. , 2002, Journal of reconstructive microsurgery.

[2]  S. Stahl,et al.  Surgical Treatment of Painful Neuroma in Medial Antebrachial Cutaneous Nerve , 2002, Annals of plastic surgery.

[3]  S. Mackinnon,et al.  Current approach to cubital tunnel syndrome. , 2001, Neurosurgery clinics of North America.

[4]  J. Wu,et al.  Painful neuromas: a review of treatment modalities. , 1999, Annals of plastic surgery.

[5]  R. Pallini,et al.  Neurosurgery of the peripheral nervous system: cubital tunnel syndrome. , 1998, Surgical neurology.

[6]  D. Pichora,et al.  Cubital tunnel syndrome and the painful upper extremity. , 1996, Hand clinics.

[7]  Kuschner Sh.  Cubital tunnel syndrome. Treatment by medial epicondylectomy. , 1996 .

[8]  H. Gellman,et al.  Modified in situ decompression of the ulnar nerve at the elbow. , 1996, Hand clinics.

[9]  R. Hotchkiss,et al.  Cubital tunnel surgery. Complications and treatment of failures. , 1996, Hand clinics.

[10]  A. Osterman,et al.  Subcutaneous transposition of the ulnar nerve for treatment of cubital tunnel syndrome. , 1996, Hand clinics.

[11]  D. Siegel.  Submuscular transposition of the ulnar nerve. , 1996, Hand clinics.

[12]  S. Mackinnon,et al.  A Technique for the Treatment of Neuroma In-Continuity , 1992, Journal of reconstructive microsurgery.

[13]  W. Kleinman,et al.  Anterior intramuscular transposition of the ulnar nerve. , 1989, The Journal of hand surgery.

[14]  D. Pichora,et al.  Surgical anatomy of the medial antebrachial cutaneous nerve. , 1989, The Journal of hand surgery.

[15]  S. Mackinnon,et al.  Treatment of the Painful Neuroma by Neuroma Resection and Muscle Implantation , 1986, Plastic and reconstructive surgery.

[16]  S. Mackinnon,et al.  Alteration of Neuroma Formation by Manipulation of Its Microenvironment , 1985, Plastic and reconstructive surgery.

[17]  S. Mackinnon,et al.  Injury to the Medial Antebrachial Cutaneous Nerve During Cubital Tunnel Surgery , 1985, Journal of hand surgery.

[18]  A. Pestronk,et al.  Implantation of Sensory Nerve into Muscle: Preliminary Clinical and Experimental Observations on Neuroma Formation , 1984, Annals of plastic surgery.

[19]  R. Leffert,et al.  Anterior submuscular transposition of the ulnar nerves by the Learmonth technique. , 1982, The Journal of hand surgery.

[20]  D. Green,et al.  Cubital tunnel syndrome. Treatment by medial epicondylectomy. , 1980, The Journal of bone and joint surgery. American volume.

[21]  A. Digiovanni.  A technique for selective blockade of the medial antebrachial cutaneous nerve. , 1969, Anesthesiology.

[22]  C. Race,et al.  Anatomic course of the medial cutaneous nerves of the arm. , 1991, The Journal of hand surgery.

[23]  R. Mann,et al.  Submuscular transposition of the ulnar nerve. , 1989, Clinical orthopaedics and related research.

[24]  S. Mackinnon.  Wandering nerve graft technique for management of the recalcitrant painful neuroma in the hand: A case report , 1988, Microsurgery.