Hereditary supracondylar spur of the humerus: Case report

Abstract

The spur or the supracondylar process variation of the humerus was first described by Struthers in 1849. The supracondylar spur has a prevalence of 0.3% - 2.7%. It is believed to represent a phylogenetic vestige of the supracondyloid foramen found in reptiles, cats and climbing animals. Three cases of supracondylar process of the humerus are presented. The main features of a supracondylar process correlated with osteochondroma are reviewed. Family relation is obvious in our case - father and two daughters. No one of them had compression symptoms or pain. They accidentally revealed the outgrowth: the father during bathing, and in two children during bathing and dressing. Radiographic findings are identical in all three cases: native radiography of the skeleton on the right elbow, on the medial side of the distal right humerus presented soft tissue shadow like the avian spur, with a broad background associated with the skeleton; suspect cartilage exostose findings. Ultrasound findings determined: ultrasonographic soft shadow, in addition to a soft tissue, suspicious for a cartilage exostosis. Also, motor and sensory functions of the nerves and muscle strength were within normal limits and Tinel and Phalen tests were negative in all three cases. No anomalies were identified on neurography and electromyography. Laboratory tests showed normal values. No one of our three patients underwent surgical interventions, because no one of them had median nerve compression or long standing pain. We suggest a follow-up of the spur’s growth in both children and to re-investigate in a 6 month interval, because of the non-completion of the spatial growth. After depiction in our cases and a review of the literature available for this kind of scenario using same aiming, it is important to emphasise the characteristics of spurs as an anatomic variant. Second is to evaluate and differentiate between osteochondroma and our findings on supracondylar processes, which will give us a hint for specific treatment in both osteochondroma and spur anomalies within coherent family incidence.