The subcutaneous plane consists mainly of adipose tissue that is abundant except over each epicondyle and on the subcutaneous border of the ulna and olecranon. This plane contains the veins, which are predominantly anterior and drain into the cephalic (lateral) and basilic (medial) veins (Fig. 1.2). The subcutaneous plane also contains the cutaneous nerves, which are located in the depth of the subcutaneous fat and just superficial to the investing fascia.1
The lateral cutaneous nerve of the forearm (C5, C6) lies adjacent to the cephalic vein and is at risk for injury during surgery on the lateral aspect of the elbow.2'3 It pierces the brachial fascia 3.2 cm proximal to the lateral epicondyle and passes 4.5 cm medial to the lateral epi-condyle. Its anterior and posterior branches supply the anterolateral and posterolateral surfaces of the forearm. The medial cutaneous nerve of the forearm (C8, T1) is also at risk of injury during elbow surgery on the medial aspect of the elbow.4'5 The posterior branch divides into two or three branches that cross anywhere from 6 cm proximal to 6 cm distal to the medial epicondyle6 (see Fig. 1.2A). Because the cutaneous nerves lie just superficial to the deep fascia, they are protected if the surgeon
creates full-thickness skin flaps.1 The anterior and posterior cutaneous nerve distribution of the upper limb is shown in Figures 1.2B and C, respectively.
The superficial lymphatics of the upper limb follow the superficial veins. Some of the lymphatics of the hand follow the basilic vein to the supratrochlear node, which is located just proximal to the medial epicondyle. Patients who have disorders of the hand may present with a tender or enlarged supratrochlear lymph node.7
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Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.