Median Nerve Release in the Forearm - Standard

Median Nerve Release in the Forearm - Standard
Authors: Mackinnon SE1, Yee A1
Published: April 22, 2013

AUTHOR INFORMATION
1Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Compression neuropathy of the median nerve in the forearm, also known as pronator syndrome, typically presents with pain in the forearm +/- paresthesia/pain in the median nerve territory. The anterior interosseous nerve can be involved with a mononeuritis. While this usually resolves without surgery, occasionally will require this approach for reconstruction or release. Related anatomical structures include the lacertus fibrosus, deep head of pronator teres, arch of flexor digitorum superficialis, and fascia in the distal arm. Release of the median nerve in the forearm addresses these structures and decompresses the nerve in this area. This release is also a method for exposing the median nerve for reconstructive options. This patient presented with median nerve neuropathy in the forearm and hand. In addition to this forearm release, a carpal tunnel release was performed. This video portrays the median nerve decompression in the forearm. For acquiring adequate proximal exposure, a distal step-lengthening of the superficial head of pronator teres is performed. While surgical anatomy can differ from patient to patient, this patient had several tendinous fasciae as well as the deep head of pronator teres.