Arcade of Struthers
Citation, DOI & article data
The arcade of Struthers is a thin fibrous aponeurotic band extending from medial head of triceps to medial intermuscular septum situated approximately 6-10 cm proximal to medial epicondyle of the humerus. In most cases this structure is due to a thickening of brachial fascia 3.
- roof and medial border
- thickened deep investing fascia of the arm
- anterior border
- medial intermuscular septum
- posterior border
- internal brachial ligament
- lateral border
- humerus covered by deep fibers of the medial head of triceps, minor posterior to the long head of triceps near its origin
- the arcade may be absent
- the arcade may come from the internal brachial ligament
- the arcade may be due to a thickened medial intermuscular septum
Under normal conditions, the arcade is not a site for ulnar nerve entrapment, but following anterior transposition procedures, the arcade of Struthers can cause entrapment as the ulnar nerve remain tethered proximally and in some cases implicated as a cause for failed cubital tunnel surgery.
History and etymology
The arcade of Struthers was not actually documented by Sir John Struthers who described the ligament of Struthers. Later researchers found the structure, however, the discovery was not without controversy, with some groups claiming it did not exist 3,4.
- 1. Sivak WN, Hagerty SE, Huyhn L, Jordan AC, Munin MC, Spiess AM. Diagnosis of Ulnar Nerve Entrapment at the Arcade of Struthers with Electromyography and Ultrasound. (2016) Plastic and reconstructive surgery. Global open. 4 (3): e648. doi:10.1097/GOX.0000000000000628 - Pubmed
- 2. Diagnosis of ulnar neuropathy in the elbow: value of ultrasonography and MRI . doi:10.1594/ecr2013/C-2216
- 4. Caetano EB, Sabongi Neto JJ, Vieira LA, Caetano MF. The arcade of Struthers: an anatomical study and clinical implications. (2017) Revista brasileira de ortopedia. 52 (3): 331-336. doi:10.1016/j.rboe.2016.07.006 - Pubmed
- 3. Tubbs RS, Deep A, Shoja MM, Mortazavi MM, Loukas M, Cohen-Gadol AA. The arcade of Struthers: An anatomical study with potential neurosurgical significance. (2011) Surgical neurology international. 2: 184. doi:10.4103/2152-7806.91139 - Pubmed