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Supracondylar Process of the Humerus

processus supracondylaris humeri

The supracondylar process (supratrochlear process) is a bony spur projecting anteromedially from the medial humeral shaft approximately 5-7 cm above the medial epicondyle, present in approximately 1-3% of individuals. It represents a vestigial third condyle present in some non-human primates. When present, it is connected to the medial epicondyle by the ligament of Struthers, forming an accessory fibro-osseous tunnel through which the median nerve and the brachial artery pass.

Region: Upper Arm

Clinical Relevance

Clinical Notes

The supracondylar process and the ligament of Struthers create a proximal median nerve entrapment that mimics carpal tunnel syndrome but with additional proximal forearm pain and pronation-related exacerbation. Suspicion is raised by median neuropathy not responding to carpal tunnel release, a visible spur on humeral radiograph, and Tinel sign high on the medial arm. Treatment requires excision of the supracondylar process and division of the ligament through a medial arm incision with care to protect the median nerve and brachial artery passing beneath the ligament.

Pathology

Common Injuries & Conditions

Median Nerve Entrapment Under Ligament of Struthers

The ligament of Struthers bridging the supracondylar process to the medial epicondyle compresses the median nerve and brachial artery in the proximal arm, producing median nerve palsy with forearm pain worsened by elbow extension; lateral humeral radiograph identifies the spur and surgical excision of both the process and ligament decompresses the nerve.