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. 2009 Jan;467(1):235-8.
doi: 10.1007/s11999-008-0535-6. Epub 2008 Oct 11.

A cadaveric study of ulnar nerve innervation of the medial head of triceps brachii

Halil Bekler  1 , Valerie M Wolfe, Melvin P Rosenwasser
Affiliations

A cadaveric study of ulnar nerve innervation of the medial head of triceps brachii

Halil Bekler et al. Clin Orthop Relat Res. 2009 Jan.

Abstract

The presence of a separately innervated muscle unit of the triceps may have possible surgical importance and can be used for motor reconstructions. The ulnar nerve is closely situated to the triceps muscle and rarely examined above the elbow. The aim of this cadaveric study was to explore a possible contribution of the ulnar nerve to motor innervation of the medial head of the triceps. We dissected 18 limbs from axillae to midforearm. The path of the ulnar nerve was followed, and examination was conducted of attachments to the triceps. Gross photographs were taken and samples histologically stained. Seventeen limbs had ulnar nerve branches proximal to the epicondyles that inserted on the medial head. Eleven of these branches were from the ulnar nerve trunk. The other six were nerve branches from the ulnar collateral branch of the radial nerve. The ulnar nerve and the ulnar collateral branch of the radial nerve are previously unrecognized sources of innervation of the medial head of the triceps brachii. These motor branches must be carefully preserved during the medial surgical approach above the elbow. The ulnar innervated part of the medial head of the triceps muscle may be used like an independent motor unit.

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Figures

Fig. 1A–B
Fig. 1A–B
(A) A photograph (×3.5 loupe magnification) and (B) diagram show the origin of the nerve branch. The arrow indicates the connective branch from the ulnar nerve to the medial head of triceps brachii. Eleven of the 18 cadaveric specimens had this gross connection, supporting our theory of ulnar innervation of at least a portion of the triceps motor function. The branch passes over the ulnar collateral branch of the radial nerve.
Fig. 2A–B
Fig. 2A–B
(A) A photograph (×3.5 loupe magnification) and (B) diagram show the presence of the accessory ulnar collateral branch of the radial nerve and the origin of the motor nerve branch. The accessory ulnar collateral branch of the radial nerve is situated close to and is grossly distinguishable from the ulnar nerve.
Fig. 3
Fig. 3
The triceps muscle and nerve branch were clearly seen on histologic examination of the specimen (Stain, Masson’s trichrome; magnification, ×40).
See this image and copyright information in PMC

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