FESSH prep Compressive neuropathies median nerve

Pronator syndrome

Reviewed by Mateusz Gładysz, MD, FEBOPRAS, FEBHS Last clinically reviewed v1.0

FESSH-003Compressive neuropathies●●○ intermediate

Regarding pronator syndrome (compressive neuropathy of the median nerve in the proximal forearm):

  1. 1.Pronator syndrome is typically characterised by nocturnal symptoms similar to carpal tunnel syndrome.

  2. 2.Resisted forearm pronation may reproduce symptoms.

  3. 3.Electrodiagnostic studies are highly reliable for diagnosing pronator syndrome.

  4. 4.The median nerve may be compressed at multiple sites in the proximal forearm, including the ligament of Struthers (when a supracondylar process is present), the lacertus fibrosus, the two heads of pronator teres, and the proximal arch of flexor digitorum superficialis.

  5. 5.Surgical decompression is indicated after failure of an adequate trial of conservative management, typically 3 to 6 months.

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