Institutional members access full text with Ovid®

Share this article on:

The Position of Crossing Branches of the Medial Antebrachial Cutaneous Nerve during Cubital Tunnel Surgery in Humans

Lowe, James B. III M.D., M.B.A.; Maggi, Sergio P. M.D.; Mackinnon, Susan E. M.D.

doi: 10.1097/01.PRS.0000130966.16460.3C
Original Articles
Advanced

The posterior branch of the medial antebrachial cutaneous nerve courses in proximity to the cubital tunnel and is particularly prone to injury during ulnar nerve release at the elbow. Inadvertent injury to medial antebrachial cutaneous nerve branches during surgery can result in the formation of painful neuromas that can be misdiagnosed as recurrent disease. It is important to understand the relevant anatomy of the medial antebrachial cutaneous nerve branches during cubital tunnel surgery to avoid significant postoperative morbidity. This prospective observational anatomic study examined the position of the posterior branch of the medial antebrachial cutaneous nerve in relationship to a standard approach to the cubital tunnel in a randomly selected group of 97 patients undergoing primary surgery over a 3-year period. Medial antebrachial cutaneous nerve branches were noted to cross at or proximal to the medial humeral epicondyle 61 percent of the time at an average proximal distance of 1.8 cm. Medial antebrachial cutaneous nerve branches were noted to cross distal to the medial humeral epicondyle 100 percent of the time at an average distal distance of 3.1 cm. Understanding the general position of crossing medial antebrachial cutaneous nerve branches during ulnar nerve release at the elbow may help to prevent iatrogenic injury to this cutaneous nerve.

St. Louis, Mo.

From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine.

Received for publication May 1, 2003; revised September 17, 2003.

James B. Lowe, III, M.D., M.B.A.

Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Mo. 63110, lowej@wustl.edu

©2004American Society of Plastic Surgeons