Ischemic brachial artery entrapment syndrome by supracondylar humeral bony spur

Medial supracondylar spur from the humerus is a rare cause of neurovascular pain of the upper extremity. The spur typically entraps the brachial artery and median nerve, resulting in compression-related symptoms. In advance stages, compression could lead to endothelial damage and thrombotic occlusion of brachial artery. Spur is also associated with an anomalous higher insertion of the pronator teres muscle, which could result in multilevel entrapment of the brachial artery. We report a patient with acute upper limb ischemia secondary to brachial artery compression and distal embolization from a medial supracondylar spur and anomalous attachment of the pronator teres. The entrapped brachial artery and median nerve were released by resection of the spur and of the anomalous belly of the pronator teres with thrombectomy of brachial artery.