![]() The lacertus fibrosus of the biceps brachii muscle: an anatomical study. Lacertus syndrome with motor and/or sensory symptoms has been addressed with a minimally invasive surgical lacertus release. Snoeck O, Lefèvre P, Sprio E, Beslay R, Feipel V, Rooze M, Van Sint Jan S. Purpose: The lacertus fibrosus (or bicipital aponeurosis) is a potential site of proximal median neuropathy at the elbow. Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study. The sublime bridge: anatomy and implications in median nerve entrapment. Tubbs RS, Marshall T, Loukas M, Shoja MM, Cohen-Gadol AA. medianus (the pronator syndrome) Acta Psychiatr Neurol Scand Suppl. pronator teres as cause of lesion of the N. Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression syndrome with prevalence rates varying between 15 of the general population resulting in approximately 600,000 carpal tunnel releases per year in the United States 1,2,3,4,5,6,7. The Lacertus syndrome can be a debilitating problem when overlooked however, it can be easily diagnosed with a careful history and physical examination. How to differentiate pronator syndrome from carpal tunnel syndrome: a comprehensive clinical comparison. Minimally invasive LR immediately restores hand strength, significantly improves DASH scores, and yields positive outcomes regarding VAS pain, numbness, and subjective satisfaction with surgery in patients with proximal median nerve entrapment at a minimum six month follow-up.Ĭarpal tunnel syndrome Median neuropathy Mononeuropathies Nerve compression syndromes Peripheral nerves.īalcerzak AA, Ruzik K, Tubbs RS, Konschake M, Podgórski M, Borowski A, Drobniewski M, Olewnik Ł. LS is a common median nerve compression syndrome typically presenting with loss of hand strength and hand endurance/fatigue. ![]() Intra-operative return of strength was verified in 99.2% of cases. Eighty-eight percent of patients reported good/excellent satisfaction with the surgical outcome. The postoperative VAS scores were pain VAS 1.9 and numbness VAS 1.8. Quick-DASH significantly improved (pre-operative 34.4 (range 2.3-84.1) to post-operative 12.4 (range 0-62.5), p < 0.0001) as did work and activity DASH (p < 0.0001). Numbness in the median nerve territory of the hand was found in all patients with combined LS and carpal tunnel syndrome. The three most common presenting symptoms in LS patients were loss of hand strength (95.6%), loss of hand endurance/fatigue (73.3%), and forearm pain (35.4%). Two-hundred-seventy-five surgical cases were identified of which 205 cases (74.5%) underwent isolated LR, and 69 cases (25.1%) concomitant lacertus and carpal tunnel release. Available DASH (Disability of the Arm Shoulder Hand questionnaire) scores and post-operative Visual Analogue Scale (VAS) of pain, numbness, subjective satisfaction with surgical outcome, and intra-operative return of strength were analyzed. This study aims to assess the clinical presentation and surgical outcomes of lacertus syndrome (LS) and concomitant median nerve entrapments.Ī retrospective study of prospectively collected data was conducted on patients undergoing lacertus release (LR) from June 2012 to June 2021.
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