Eighty-eight percent of patients reported good/excellent satisfaction with the surgical outcome. The mean post-operative VAS scores were as follows: pain VAS 1.9 numbness VAS 1.8 satisfaction with the surgical outcome VAS 8.5. ***Statistically significant changes in pre- and post-operative scores ( p < 0.0001)

Cross marks the average, and dot indicates outliers outside the whiskers. The boxes show the median and interquartile range, and the whiskers show the 25th and 75th percentiles. Available pre-and post-operative quick-DASH (Disability of the Arm Shoulder Hand questionnaire) with work and activity sub-scores and post-operative Visual Analogue Scale (VAS) of pain, numbness, subjective satisfaction with the surgical outcome, and intra-operative return of strength were analyzed.īox-and-whisker plots showing the results of pre-operative and post-operative quick-DASH, work-DASH, and activity-DASH scores. Medical charts were reviewed, and data on sex, age, occupation, hand dominance, reported subjective symptoms, surgical treatment, and intra-operative return of strength were collected. Patients surgically treated with concomitant peripheral nerve compressions other than the median nerve were excluded. Patients were included for final evaluation if they had undergone surgical decompression of the median nerve at the level of the LF (lacertus release), with or without simultaneous concomitant carpal tunnel or other median nerve releases. A retrospective study of prospectively collected data was conducted on the patient registry from June 2012 to June 2021. Ethics committee approval and due consent were also obtained. This study involving human participants was in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments. In fact, due to the nerve topography and dynamic nature of entrapment caused by the LF, commonly known as lacertus syndrome (LS), its symptomatology often goes unnoticed. Its dynamic biomechanical role in force transmission during elbow flexion, lever arm adjustment, and supination restraint could also explain its dynamic compression over the median nerve. The lacertus fibrosus (LF) is an aponeurosis originating from the medial border of the distal biceps brachialis tendon, directed medially and distally, and in direct contact with the median nerve in almost half of individuals, crossing over the common flexor muscle mass and blending with its fascia (Fig. However, recent research has challenged which structure is primarily responsible for compression and the extent of the surgical release required to relieve symptoms. Henrik Seyffarth first described it as pronator syndrome in 1951, a nerve compression between the humeral and ulnar head of the pronator teres muscle, usually presenting a fibrous band between them. Proximal median nerve entrapment (PMNE) has attracted the interest of hand surgeons over the last decade.

Lacertus syndrome