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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2024, Number 2

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Ortho-tips 2024; 20 (2)

Lacertus fibrosus syndrome: case series of immediate postoperative results

Castillo DAA, Pérez SFA, Sánchez GLE

Language: Spanish
References: 17
Page: 80-88
PDF size: 277.62 Kb.


ABSTRACT

Introduction: compression of the median nerve at the proximal level of the forearm by the lacertus fibrosus, the main compressive structure in this area and responsible for lacertus syndrome, may have a much higher incidence than previously believed; in recent studies where it has been observed little or no improvement with surgical treatment in patients with apparent carpal tunnel syndrome, it is necessary to consider and intentionally rule out suspicion of compressive neuropathies of the median nerve. Objective: to report our results after surgical decompression of the median nerve at the proximal level of the forearm due to lacertus fibrosus in the Mexican population. Material and methods: surgical release was performed in 8 cases of median nerve compression at the proximal level of the forearm with pre-surgical and post-surgical measurement at four weeks of grip strength, lateral pinch strength, pain (visual analogue scale: VAS) and functionality (q-DASH) of the affected limb. Results: seven patients underwent surgery with 8 releases of the lacertus fibrosus; A decrease in the q-DASH score of 94%, an increase in grip strength of 44.9%, a lateral grip of 100% and an improvement in the VAS of 82.1% were found. Conclusions: compression of the median nerve by the lacertus fibrosus should be considered and suspected by the personal physician as part of the differential diagnoses in the presence of a compressive neuropathy of the median nerve at the proximal level of the forearm. It should no longer be considered as a rare pathology frequent or rare.


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