Eur J Anat, 23 (4): 301-305 (2019)

The debatable Arcade of Struthers: is it still time to consider it?

Marco Guidi¹, Valentin Neuhaus², Bartolomeo Scarsi³, Maurizio Calcagni¹, Andreas Prescher⁴, Bernhard Dimitri Ciritsis³

¹Dept. of Plastic Surgery and Hand Surgery, Universitätspital Zürich, Switzerland, ²Dept. of Traumatology, Universi-tätspital Zürich, Switzerland, ³Orthopaedic Dept., Regional Hospital San Giovanni, Bellinzona, Switzerland, ⁴Institute of Molecular and Cellular Anatomy, University of Aachen, Germany

ABSTRACT The Arcade of Struthers is reported to be a structure that may play a role in ulnar nerve compression in the arm. The aim of this research is to better understand the relationship between the ulnar nerve and this anatomical structure of the medial aspect of the arm, and to investigate its morphology. In 54 fresh arms (26 female, 28 male, 24 left and 30 right limbs), with a median age of 67 years (range 45-83 years), the ulnar nerve and all the surrounding structures were dissected from the brachial plexus to the ulnar groove of the medial epicondyle. We identified muscular fibers from the medial head of the triceps over the ulnar nerve in 12 examined limbs (24%). In all specimens the ulnar nerve was not compressed by any band and no sign of hourglass constriction was found. The extension of the muscular fibers was 34mm (min 20 mm, max 51 mm) and their average distance from the medial epicondyle was 61 mm (min 25 mm, max 80 mm). The findings of this study are not supportive for the presence of an arcade as previously described. Although this structure was reported to be a rare site of ulnar nerve compression at the elbow, it was not described by Struthers. The terminology â??Arcade of Struthersâ?� seems to be misleading due to the similarity with the other eponym â??Ligament of Struthersâ?�.

Keywords: Arcade of Struthers â?? Internal brachial ligament â?? Medial intermuscular septum â?? Ulnarnerve â?? Entrapment â?? Anatomical study â?? Compressive neuropathy