![]() 2Ĭlip 20-2 Clinical examination of lacertus syndrome. Compartment Syndrome of the forearm is a condition in which pressure inside the closed osteofascial compartment increases to such an extent that there is a compromise of microcirculation, leading to tissue damage1. You make the diagnosis of lacertus syndrome through a history and a thorough physical motor examination. median nerve to be temporarily compressed by the lacertus. It occurs normally after strenuous and prolonged exercise. You will not make this diagnosis with nerve conduction studies. teres syndrome and even less frequent anterior interosseous nerve syndrome, which owing to the. (lakt-as-dm-) lactacid + -emia Excessive accumulation of lactic acid in the blood. ![]() Pain over the median nerve at the medial edge of the lacertus fibrosus 1Ī positive scratch collapse test over the median nerve at the elbowĬlip 20-2 demonstrates clinical examination of lacertus syndrome showing weakness of FCR, FDP2, FPL, tenderness under lacertus fibrosis, and positive scratch collapse test.Īlthough less prominent than motor signs, sensory symptoms in the median nerve distribution are present in some patients, especially in the palmar cutaneous branch distribution.Ĭonsider this diagnosis if patients complain of weakness or numbness in the palmar cutaneous distribution, or after failed carpal tunnel release. It occurs when the median nerve is compressed at the elbow under a sheet of ligamentous tissue called the lacertus fibrosus. Weakness in the flexor carpi radialis (FCR), flexor pollicis longus (FPL), and flexor digitorum profundus muscles of the index finger (FDP2) should know What is lacertus syndrome Lacertus syndrome is a common hand condition, but the general public and even many health professionals aren’t very familiar with it. You make the diagnosis of lacertus syndrome on a clinical examination triad consisting of: Clip 20-1 What is lacertus syndrome? It is a simple procedure, similar to carpal tunnel release with WALANT. Thoracic outlet syndrome (TOS) refers to a constellation of signs and symptoms that arise from compression of the neurovascular bundle by various structures in the area just above the first rib and behind the clavicle, within the confined space of the thoracic outlet 1-5. Diagnosis can be made with a careful neurological exam (weakness of thumb, index and middle finger flexion) with inability to make OK sign and normal median nerve sensory exam. Lacertus syndrome: Use of pre- and post-exercise MRI to aid in diagnosis and treatment Radiol Case Rep. You can easily release this with good results in the right patients, as described in Clip 20-1. Compression of the AIN nerve (also known as Kiloh-Nevin's syndrome) is a forearm compressive neuropathy that results in motor deficits of the AIN nerve. ![]() Several case studies exist to document the lacertus fibrosus as a potential site of median nerve entrapment. Lacertus syndrome is characterized by compression of the median nerve under the lacertus fibrosus (bicipital aponeurosis) at the elbow. Lacertus Fibrosus Compression The lacertus fibrosus, or bicipital aponeurosis, ex-tends obliquely from the biceps tendon across the antecubital fossa to the fascia overlying the flexor forearm muscles22 (Figure 4). Chapter 20 Lacertus Syndrome: Median Nerve Release at the Elbow Elisabet Hagert, Donald H. ![]()
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