Struthers' ligament

Diagram showing location of Struthers' ligament
Illustration by John Struthers, 1854:[1]
a) osseous process
b) ligament

Struthers' ligament is a feature of human anatomy consisting of a band of connective tissue at the medial aspect of the distal humerus. It courses from the supracondylar process of the humerus (also known as avian spur) to the medial epicondyle of the humerus.[2] It is not a constant ligament, and can be acquired or congenital.[3][4][5] The structure was highlighted by John Struthers, who discussed the feature's evolutionary significance with Charles Darwin. Struthers originally reported that the ligament usually arose at a position 3.2 to 6.4 cm from the medial condyle, being 1.2 to 1.9 cm in length, and nearer to the anterior than the medial border of the humerus.[1]

The clinical significance of this structure is due to the median nerve and brachial artery which may pass underneath the "arch" formed by the process and ligament over the humeral body. Within this space the nerve may be compressed leading to supracondylar process syndrome.[6][7][8][9] the arcade of Struthers is located nearby and is a fascial band running between the medial head of triceps and the medial inter muscular septum, it is a distinct entity to the ligament of Struthers. The arcade is involved in ulnar nerve compression, usually post transposition, the ligament is not. [10]

  1. ^ a b Struthers, John, 1854. "On some points in the abnormal anatomy of the arm".
  2. ^ De Jesus R, Dellon AL (May 2003). "Historic origin of the "Arcade of Struthers"". J Hand Surg Am. 28 (3): 528–31. doi:10.1053/jhsu.2003.50071. PMID 12772116.
  3. ^ Hommel U, Bellée H, Link M (1989). "[The validity of parameters in neonatal diagnosis and fetal monitoring of breech deliveries. 1. Neonatal status after breech delivery]". Zentralbl Gynakol (in German). 111 (19): 1293–9. PMID 2588859.
  4. ^ Varlam H, St Antohe D, Chistol RO (September 2005). "[Supracondylar process and supratrochlearforamen of the humerus: a case report and a review of the literature]". Morphologie (in French). 89 (286): 121–5. doi:10.1016/S1286-0115(05)83248-5. PMID 16444940.
  5. ^ Dellon AL, Mackinnon SE (October 1987). "Musculoaponeurotic variations along the course of the median nerve in the proximal forearm". J Hand Surg Br. 12 (3): 359–63. doi:10.1016/0266-7681(87)90189-6. PMID 3437205.
  6. ^ Wertsch JJ, Melvin J (December 1982). "Median nerve anatomy and entrapment syndromes: a review". Arch Phys Med Rehabil. 63 (12): 623–7. PMID 6756339.
  7. ^ Bilecenoglu B, Uz A, Karalezli N (April 2005). "Possible anatomic structures causing entrapment neuropathies of the median nerve: an anatomic study". Acta Orthop Belg. 71 (2): 169–76. PMID 16152850.
  8. ^ Nigst H, Dick W (April 1979). "Syndromes of compression of the median nerve in the proximal forearm (pronator teres syndrome; anterior interosseous nerve syndrome)". Arch Orthop Trauma Surg. 93 (4): 307–12. doi:10.1007/BF00450231. PMID 464765. S2CID 10677076.
  9. ^ Kett K, Csere T, Lukács L, Szilágyi K, Illényi L (June 1979). "Histological and autoradiographic changes in locally irradiated lymph nodes (an experimental study on rabbits)". Lymphology. 12 (2): 95–100. PMID 491743.
  10. ^ Campbell, William W.; Landau, Mark E. (2008). "Controversial Entrapment Neuropathies". Neurosurgery Clinics of North America. 19 (4): 597–608. doi:10.1016/j.nec.2008.07.001. PMID 19010284.