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The Crossing Motor Ulnar Nerve Branch at Elbow
Sonia S Majid1, Neel T Patel1, Oliver D Mrowczynski1
1Department of Neurosurgery, Pennsylvania State University College of Medicine, Hershey , Pennsylvania , USA.
Operative Neurosurgery (Hagerstown, Md.)
|September 2, 2024
Summary
A common motor branch crossing the ulnar nerve during cubital tunnel release surgery was identified in 71% of cadavers. Awareness of this anatomy is key to preventing nerve injury during ulnar nerve decompression.
Area of Science:
- Anatomy
- Surgical Anatomy
- Nerve Entrapment Syndromes
Background:
- Cubital tunnel syndrome is a prevalent nerve entrapment.
- Anatomical understanding is vital for successful ulnar nerve release.
- A frequently encountered, yet poorly documented, motor branch crosses the ulnar nerve during surgery.
Purpose of the Study:
- To anatomically characterize a specific motor branch encountered during cubital tunnel release.
- To determine the prevalence and location of this crossing motor branch.
- To discuss the clinical significance of this branch in ulnar nerve decompression.
Main Methods:
- Cadaveric dissection of 48 elbow specimens.
- Assessment for the presence of the crossing motor branch of the ulnar nerve.
- Measurement of branch takeoff and target innervation distances from the medial epicondyle.
Main Results:
- A crossing motor branch was present in 34 (71%) of the dissected specimens.
- The branch was typically located at the deep flexor carpi ulnaris muscle fascia.
- Average distances: 18.2 mm from the medial epicondyle to takeoff, 28.4 mm to innervation.
Conclusions:
- The identified crossing motor branch is a significant anatomical finding during cubital tunnel release.
- Surgeons must be aware of this branch to avoid iatrogenic injury.
- Understanding this anatomy can improve outcomes of ulnar nerve decompression procedures.
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