J Korean Soc Surg Hand.  2016 Mar;21(1):8-15. 10.12790/jkssh.2016.21.1.8.

Comparison of Cubital Tunnel Syndrome with or without Anconeus Epitrochlearis: Are They Different?

• Yoon MG
• Yoo MJ
• Kim JM
• Paeng JW
• Kim YW
• Woo SH

• KMID: 2161158
• DOI: http://doi.org/10.12790/jkssh.2016.21.1.8

Abstract

PURPOSE
To assess the clinical difference between cubital tunnel syndrome with anconeus epitrochlearis (AE) and idiopathic cubital tunnel syndrome without known other causes.
METHODS
This cross-sectional study included the 326 patients who were subjected to surgery because of cubital tunnel syndrome from 2008 to 2014. After exclusion of patients with other known causes of cubital tunnel syndrome, a total of 107 patients were divided into two groups; patients with and without AE. The clinical differences between two groups were analyzed retrospectively; age, sex, presence of intrinsic muscle atrophy, interval from symptom development to surgery, pinch power, the disabilities of the arm, shoulder and hand score and the nerve conduction velocity (NCV).
RESULTS
Thirty four (10.4%) patients, being subjected to surgery had the AE. Among 107 patients who had no other known causes, 26 patients had AE. 19 out of 26 patients with AE was male. Average age of patients with AE was significantly younger. The interval from symptom development to surgery in AE patients was significantly shorter. Motor NCV of ulnar nerve at above elbow joint in comparison with that at below elbow joint in AE patient was more significantly decreased (14.3 m/sec vs. 8.3 m/sec).
CONCLUSION
The AE in cubital tunnel syndrome is no more rare structure. In younger male patients with rapidly progressive worsening cubital tunnel symptoms, and if there is significant decrease of ulnar motor nerve velocity at above elbow in comparison with at below elbow, the AE should be considered as cause of ulnar neuropathy.

Keyword

Cubital tunnel syndrome; Ulnar nerve; Anconeus epitrochlearis

MeSH Terms

Arm
Cross-Sectional Studies
Cubital Tunnel Syndrome*
Elbow
Elbow Joint
Hand
Humans
Male
Muscular Atrophy
Neural Conduction
Retrospective Studies
Shoulder
Ulnar Nerve
Ulnar Neuropathies

Figure

• 

  Fig. 1. A fifty-eight year-old patient had surgery for cubital tunnel syndrome. The interval from symptom development to surgery was about 12 months and she had no atrophy of intrinsic muscle of her left hand. The anconeus epitrochlearis (white arrow) was noted as intermediate signal on T1 (A), T2 (B)-weighted magnetic resonance imaging of her elbow. (C) Thick anconeus epitrochlearis (black arrows) cover the ulnar nerve (black arrow head) and make a roof of cubital tunnel of her left elbow. (D) After excision of the muscle, swollen ulnar nerve (black arrow head) is exposed with tension free in the tunnel.

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