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Osborne ’ s Ligament: A Review of its History, Anatomy, and Surgical Importance

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ABSTRACT

When discussing the pathophysiology of ulnar neuropathy, Geoffrey Vaughan Osborne described a fibrous band that can be responsible for the symptoms seen in this disorder. In this paper, we take a glimpse at the life of Osborne and review the anatomy and surgical significance of Osborne’s ligament. This band of tissue connects the two heads of the flexor carpi ulnaris and thus forms the roof of the cubital tunnel. To our knowledge, no prior publication has reviewed the history of this ligament, and very few authors have studied its anatomy in any detail. Therefore, the aim of the present paper is to elucidate this structure that is often implicated and surgically transected to decompress the ulnar nerve at the elbow.

No MeSH data available.


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Drawing of Osborne’s ligamentNote the entrapment site at the postcondylar groove with a pseudoneuroma of the ulnar nerve proximal to the ligament (Published with permission from [5]).
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FIG2: Drawing of Osborne’s ligamentNote the entrapment site at the postcondylar groove with a pseudoneuroma of the ulnar nerve proximal to the ligament (Published with permission from [5]).

Mentions: A comprehensive knowledge of the anatomy of the elbow is essential for diagnosing and treating nerve pathology in this location. With regard to ulnar nerve compression at the elbow, although the exact site is controversial, the cubital tunnel has been implicated as one site of ulnar nerve entrapment [1-6]. In 1957, Osborne described a band of fibrous tissue that spanned between the humeral and ulnar heads of the flexor carpi ulnaris (FCU) muscle and thus formed the roof of the cubital tunnel (Figures 1-2). The cubital tunnel is the fibromuscular canal where the ulnar nerve traverses between the two heads of the FCU with a floor composed of the medial collateral ligament, olecranon, and joint capsule. The so-called Osborne’s ligament has also been referred to as the arcuate ligament of Osborne [7], the cubital tunnel retinaculum [8], Osborne’s fascia [3], Osborne’s band [9], or simply the arcuate ligament or tendinous arch [10] and with Osborne’s publications in the 1950s, was considered as one of the causes of ulnar neuritis [5]. Prior to Osborne’s description of this band of tissue, it was rarely mentioned in the English and French literature [11]. As background, although traumatic ulnar nerve dysfunction was described by Panas as early as 1878, it was not until the early 1900s when Hunt reported spontaneous nerve dysfunction [12-13]. Structural reasons (e.g., ganglion cyst) for these latter presentations were reported by Seddon in 1952 [14]. Five years later, Osborne reported 25 cases of ulnar neuropathy at the elbow and in “almost every case” found compression of the nerve by a fibrous band bridging the two heads of the FCU muscle [15]. Therefore, based on the publications of those such as Seddon and Osborne, non-traumatic structural lesions as a cause of ulnar nerve compression became a widely accepted cause of ulnar neuropathy.


Osborne ’ s Ligament: A Review of its History, Anatomy, and Surgical Importance
Drawing of Osborne’s ligamentNote the entrapment site at the postcondylar groove with a pseudoneuroma of the ulnar nerve proximal to the ligament (Published with permission from [5]).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383373&req=5

FIG2: Drawing of Osborne’s ligamentNote the entrapment site at the postcondylar groove with a pseudoneuroma of the ulnar nerve proximal to the ligament (Published with permission from [5]).
Mentions: A comprehensive knowledge of the anatomy of the elbow is essential for diagnosing and treating nerve pathology in this location. With regard to ulnar nerve compression at the elbow, although the exact site is controversial, the cubital tunnel has been implicated as one site of ulnar nerve entrapment [1-6]. In 1957, Osborne described a band of fibrous tissue that spanned between the humeral and ulnar heads of the flexor carpi ulnaris (FCU) muscle and thus formed the roof of the cubital tunnel (Figures 1-2). The cubital tunnel is the fibromuscular canal where the ulnar nerve traverses between the two heads of the FCU with a floor composed of the medial collateral ligament, olecranon, and joint capsule. The so-called Osborne’s ligament has also been referred to as the arcuate ligament of Osborne [7], the cubital tunnel retinaculum [8], Osborne’s fascia [3], Osborne’s band [9], or simply the arcuate ligament or tendinous arch [10] and with Osborne’s publications in the 1950s, was considered as one of the causes of ulnar neuritis [5]. Prior to Osborne’s description of this band of tissue, it was rarely mentioned in the English and French literature [11]. As background, although traumatic ulnar nerve dysfunction was described by Panas as early as 1878, it was not until the early 1900s when Hunt reported spontaneous nerve dysfunction [12-13]. Structural reasons (e.g., ganglion cyst) for these latter presentations were reported by Seddon in 1952 [14]. Five years later, Osborne reported 25 cases of ulnar neuropathy at the elbow and in “almost every case” found compression of the nerve by a fibrous band bridging the two heads of the FCU muscle [15]. Therefore, based on the publications of those such as Seddon and Osborne, non-traumatic structural lesions as a cause of ulnar nerve compression became a widely accepted cause of ulnar neuropathy.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

When discussing the pathophysiology of ulnar neuropathy, Geoffrey Vaughan Osborne described a fibrous band that can be responsible for the symptoms seen in this disorder. In this paper, we take a glimpse at the life of Osborne and review the anatomy and surgical significance of Osborne’s ligament. This band of tissue connects the two heads of the flexor carpi ulnaris and thus forms the roof of the cubital tunnel. To our knowledge, no prior publication has reviewed the history of this ligament, and very few authors have studied its anatomy in any detail. Therefore, the aim of the present paper is to elucidate this structure that is often implicated and surgically transected to decompress the ulnar nerve at the elbow.

No MeSH data available.


Related in: MedlinePlus