Os subepicondylare mediale ossicle as a cause for cubital tunnel syndrome: A case report

doi:10.12998/wjcc.v14.i16.120594

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Jun 6, 2026; 14(16): 120594
Published online Jun 6, 2026. doi: 10.12998/wjcc.v14.i16.120594

Os subepicondylare mediale ossicle as a cause for cubital tunnel syndrome: A case report

Arulkumar Nallakumarasamy, Sanjey Sivakumar, Vinnisa Nithiakala Vetrivel, Vinoth Prabhu Balaji, Norton Stephen, Naveen Jeyaraman, Madhan Jeyaraman

Arulkumar Nallakumarasamy, Sanjey Sivakumar, Department of Orthopaedics, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India

Vinnisa Nithiakala Vetrivel, Department of Obstetrics & Gynecology, Vinayaka Mission Medical College and Hospital, Karaikal 609609, Puducherry, India

Vinoth Prabhu Balaji, Department of Orthopaedics, Government General Hospital, Karaikal 609602, Puducherry, India

Norton Stephen, Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Karaikal 609602, Puducherry, India

Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India

Naveen Jeyaraman, Madhan Jeyaraman, Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine, Chennai 600030, Tamil Nadu, India

Co-first authors: Arulkumar Nallakumarasamy and Sanjey Sivakumar.

Author contributions: Nallakumarasamy A and Jeyaraman N designed the research; Nallakumarasamy A, Sivakumar S, Vetrivel VN, Balaji VP, Stephen N, and Jeyaraman M analyzed articles for the review and wrote the manuscript; Jeyaraman M finalized the manuscript.

Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: The authors declare no conflict of interest in the manuscript.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Madhan Jeyaraman, MD, PhD, Researcher, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com

Received: March 3, 2026
Revised: April 2, 2026
Accepted: April 30, 2026
Published online: June 6, 2026
Processing time: 80 Days and 14.5 Hours

Abstract

BACKGROUND

Cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome after carpal tunnel syndrome. It involves compression of the ulnar nerve at the elbow, leading to pain, numbness, and weakness.

CASE SUMMARY

A 42-year-old male patient reported left elbow pain, tingling in the ring and small fingers, and a weak grip for 2 years. An X-ray revealed os subepicondylare mediale, a rare accessory ossicle that compressed the ulnar nerve. Decompression surgery and ossicle excision greatly improved symptoms and recovery.

CONCLUSION

Accessory ossicles are an important consideration in the differential diagnosis of ulnar neuropathy, and surgery has been shown to be an effective treatment in such cases.

Keywords: Cubital tunnel; Os subepicondylare; Medial ossicle; Ulnar nerve; Nerve entrapment; Case report

Core Tip: A 42-year-old male patient with cubital tunnel syndrome caused by an unusual accessory ossicle, os subepicondylare mediale, presented with elbow pain, finger tingling, and a weak grip. Imaging confirmed ulnar nerve compression. Surgical decompression with ossicle removal led to improvement in symptoms and function, highlighting the importance of considering accessory ossicles in ulnar neuropathy and the effectiveness of surgical treatment.