Illustrated Encyclopedia of Human Anatomic Variation: Opus V: Skeletal Systems: Upper Limb

Arm: Humerus

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

The humeral head may be absent.

The humerus may have an enlarged deltoid process.

The olecranon fossa of the humerus is occasionally perforated to form a supratrochlear foramen or septal aperature. Septal aperatures may occur in 4-13% of individuals, more frequently on the left side and in females. Racial variations of 4.1-58% have been reported. In an examination of 1744 arm bones, Trotter found septal apertures in 4.2% of whites and 12.8% of American Negroes.

A hook-like, bony spine of variable size, the supracondylar process, may project distally from the anteromedial surface of the humerus, about 5 cm proximal to the medial epicondyle. It is joined to the epicondyle by a fibrous band (so-called ligament of Struthers) which may ossify. The process, band and shaft of the humerus form a ring or canal through which the median nerve and the brachial artery (or a branch of it) are transmitted. The nerve and/or artery may become compressed causing clinical symptoms.

Occasionally, only the median nerve traverses the canal.

The bony process and ligament sometimes provides origin for a part of the pronator teres muscle, as well an insertion site for a portion of coracobrachialis.

The supracondyloid process of the humerus has a reported frequency of 2.7% (Gruber). Adachi summarized the literature (up to 1828) and found 12 authors (not including Gruber) had studied 9620 humeri and identified supracondylar processes in 78 or 0.8% of arms. The range of frequency in the 12 studies was 0.1-5.7%. The peoples studied included the Aino, Chinese, Koreans, Negroes, Melanesians, Australians, Japanese (including 142 stone age specimens), East Indians, Germans, French, Eskimos, Swedes, and Italians.

Gruber (1865) remarked, "this knowledge cannot be entirely without interest to the surgeon".

A sesamoid bone is frequently found in the tendon of insertion of the triceps muscle.

Robert Spinner et al. point out that Tiedemann first described the process in 1818, followed by Knox in 1841 and by Struthers in 1849.

Supracondylar Process

Supracondylar Process. Supratrochlear Foramen.

Image 69

Views of trhe Upper End of the Left Humerus

The Struthers Structural Complexes of the Arm

References

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