The anatomical variations of the cubital tunnel in a South African body donor sample

TL;DR

This study examines the anatomical variations of the cubital tunnel in South African donors and finds differences in size and structure between sexes and sides of the body.

Contribution

The study provides new insights into the anatomical variations of the cubital tunnel in a South African population.

Findings

The cubital tunnel roof was mostly formed by the cubital tunnel retinaculum (95%) rather than the anconeus epitrochlearis (5%).

The cubital tunnel was longer in males and wider on the right side.

The anconeus epitrochlearis was thicker and associated with a larger ulnar nerve diameter.

Abstract

The ulnar nerve (UN) courses through the cubital tunnel, which is a potential site of entrapment. Anatomical variations of the cubital tunnel may contribute towards cubital tunnel syndrome (CuTS), however, these are not well described. The aim was to compare the range of variations and dimensions of the cubital tunnel and the UN between sexes and sides of the body.

Sixty elbows from 30 embalmed bodies (17 males and 13 females) were dissected. The prevalence of the cubital tunnel retinaculum (CuTR) or anconeus epitrochlearis (AE) forming the roof of the tunnel was determined. The length, width, thickness, and diameter of the cubital tunnel and its roof were measured. The diameter of the UN was measured.

The AE was present in 5%, whereas the CuTR was present in the remaining 95% of elbows. The tunnel was 32.1 ± 4.8 mm long, 23.4 ± 14.2 mm wide, 0.18 ± (0.22–0.14) mm thick, and the median diameter was 7.9 ± (9.0–7.1) mm, while the median diameter of the UN was 1.6 ± (1.8–1.3) mm. The AE was thicker than the CuTR (p < 0.001) and the UN was larger in elbows with the AE present (p = 0.002). The tunnel was longer in males (p < 0.001) and wider on the right (p = 0.014).

The roof of the cubital tunnel was more frequently composed of the CuTR. The cubital tunnel varied in size between sexes and sides. Future research should investigate the effect of the variations in patients with CuTS.

The online version contains supplementary material available at 10.1007/s00276-024-03327-8.

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