Operative treatment of pronator syndrome
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Decompression of the median nerve in the area of the pronator teres.
Symptoms persisting after proper conservative care.
Presence of motor deficits.
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 WordsMedian nerve Entrapment neuropathy Pronator teres Pronator syndrome
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