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A supratrochlear spur, also known as a supracondylar spur or supracondylar process, is an anatomical variant found in approximately 1% of the population. It is located on the anteromedial humeral cortex, about 5 centimeters proximal to and pointing towards the medial epicondyle of the humerus. This bony projection is often considered a vestigial structure. Interestingly, a similar structure called the supracondylar canal (or foramen) can be found in many more primitive mammals, such as felines. The ligament of Struthers may also be present in association with the supratrochlear spur. This ligament joins the tip of the spur with the medial epicondyle, forming a supracondylar canal through which the median nerve and brachial artery pass. The ligament of Struthers is thought to represent the vestigial third head of the coracobrachialis muscle. In human fetuses, the two main heads of the coracobrachialis surround the musculocutaneous nerve and then fuse, explaining why the nerve passes through the muscle. Most patients with a supratrochlear spur are asymptomatic, but it should be considered if patients present with symptoms of median nerve compression and there is no pathology in the carpal tunnel on imaging. Additionally, this anatomical variant can lead to compression of the brachial artery. Radiographically, the supratrochlear spur appears as a small bony projection projecting anteromedially from the humeral metadiaphysis towards the elbow joint on plain radiographs. Treatment and prognosis depend on individual cases and associated complications, such as supracondylar process syndrome (which involves neuropathy of the median nerve) and brachial artery compression. In summary, the supratrochlear spur is a fascinating example of anatomical variation in the humerus, and its presence can have clinical implications in certain situations. #Supratrochlearspur