Orthopaedics and Traumatology

, Volume 7, Issue 1, pp 34–43 | Cite as

Operative treatment of pronator syndrome

  • Akio Matsuzaki
Classical Procedures



Decompression of the median nerve in the area of the pronator teres.


Symptoms persisting after proper conservative care.

Presence of motor deficits.


Poor health.

Surgical Technique

Incision over the tender point. Exposure and division of the lacertus fibrosus. Identification of the median nerve and search for evidence of compression. Look for anatomical variations. Follow nerve distally and search for a bridge of the flexor digitorum superficialis.


Report of 21 patients (7 men and 14 women, average age 57.7 years, 23 to 82 years). Three patients had bilateral surgery. Seventeen times another entrapment neuropathy was present. Average follow-up period 26 months (3 to 148 months). Except for 2 patients who experienced a recurrence, all patients were relieved of their symptoms. Disappearance of dysaesthesia was seen in 1 patient on the day of surgery. Dysaesthesia improved or disappeared in 11 patients within 1 week and in 6 between 1 and 2 weeks. In 3 patients the outcome was not recorded. A postoperative haematoma was observed twice. No other complications were noted.

Key Words

Median nerve Entrapment neuropathy Pronator teres Pronator syndrome 


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  1. 1.
    Beaton LE, Anson BJ. The relation of the median nerve to the pronator teres muscle. Anat Rec 1939;75:23–6.CrossRefGoogle Scholar
  2. 2.
    Dawson DM, Hallet M, Millender LH. Entrapment neuropathies. Boston-Toronto: Little, Brown and Company, 1983:P66–70.Google Scholar
  3. 3.
    Dellon AL, Mackinnon SE. Musculoaponeurotic variations along the course of the median nerve in the proximal forearm. J Hand Surg [Br] 1987;12:359–63.Google Scholar
  4. 4.
    Johnson RK, Spinner M, Shrewsbury MM. Median nerve entrapment syndrome in the proximal forearm. J Hand Surg [Am] 1979:4:48–51.Google Scholar
  5. 5.
    Kelly MJ, Jackson BT. Compression of median nerve at elbow. Br Med J 1976;2:283.CrossRefPubMedGoogle Scholar
  6. 6.
    Kopell HP, Thompson WAL. Pronator syndrome. N Engl J Med 1958;259:713–5.PubMedCrossRefGoogle Scholar
  7. 7.
    Lanz T von, Wachsmuth W. Praktische Anatomie, Bd. 1, Teil III: Arm. Berlin-Göttingen-Heidelberg: Springer 1959.Google Scholar
  8. 8.
    Morris HH, Peters BH. Pronatorsyndrome: clinical and electrophysiological features in severe cases. J Neurol Neurosurg Psychiat 1976;39:461–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Nigst H. Kompressionssyndrom des Nervus medianus im Ellenbogenbereich. Operat Orthop Traumatol 1993;5:40–7.CrossRefGoogle Scholar
  10. 10.
    Solnitzky O. Pronator syndrome: compression neuropathy of the median nerve at level of the pronator teres muscle. Med Bull (Georgetown) 1960;13:232–8.Google Scholar
  11. 11.
    Upton ARM, McComas AJ. The double crush in nerve entrapment syndromes. Lancet 1973;18:359–62.CrossRefGoogle Scholar
  12. 12.
    Werner CO, Rosen I, Thorngren KG. Clinical and neurophysiologic characteristics of the pronator teres syndrome. Clin Orthop 1998;197:231–6.Google Scholar

Copyright information

© Urban & Vogel 1999

Authors and Affiliations

  • Akio Matsuzaki
    • 1
  1. 1.Department of Orthopaedic Surgery Chikushi HospitalFukuoka UniversityChikushino CityJapan

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