CYPRUS HAND SURGERY · PAPHOS & LIMASSOL
Lacertus syndrome
Lacertus syndrome describes compression of the median nerve beneath a fibrous band near the elbow. It is a different compression site from carpal tunnel syndrome at the wrist, although both can occur in the same arm.
Symptoms and examination
Reported symptoms include reduced pinch or grip strength, hand fatigue and forearm discomfort. These symptoms are not specific to lacertus syndrome. Assessment examines muscle strength and tenderness and considers other nerve, tendon or neck problems. Nerve tests may be normal, so they are interpreted in the context of the full clinical assessment. Hagert: clinical diagnosis and treatment study.
Discussing treatment
The first task is to establish whether this compression explains the functional problem. Your consultation can consider activity changes, therapy and whether decompression is appropriate. Surgery releases the band over the nerve; selected releases can be performed with WALANT local anaesthesia.
Published surgical series report improvement in selected patients, but these results do not guarantee an individual outcome or prove surgery is necessary for everyone. Coexisting nerve compression may require separate consideration. Hagert and colleagues: 275 surgical cases.
Planning recovery
Before deciding on surgery, discuss the expected benefit, uncertainty, risks to nearby structures, wound care and a plan for rebuilding activity. Early changes in strength are not the same as complete recovery. Bring details of work and hobbies that involve repeated gripping or forearm rotation so practical restrictions can be agreed.
Compare information on carpal tunnel syndrome and radial tunnel syndrome.
Related images and demonstrations
View the relevant procedure material in our treatment directory. Clinical demonstrations show selected examples and do not predict your own outcome.