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Lacertus syndrome: recent advances.

Thomas Apard1, Vincent Martinel2, Greg Batby3

  • 1Ultrasound Guided Hand Surgery Center, 2 Rue de Tocqueville, 78000 Versailles, France; Private Hospital Les Franciscaines, 7 Route de la Porte de Buc, 78000 Versailles, France.

Hand Surgery & Rehabilitation
|June 9, 2024
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Summary

Lacertus syndrome, a median nerve entrapment, causes hand weakness and forearm pain. Accurate diagnosis relies on clinical exams, with non-operative and surgical treatments showing promising outcomes.

Keywords:
ElbowEntrapmentLacertusMedian nerveSurgeryWALANT

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Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Anatomy

Background:

  • Lacertus syndrome involves proximal median nerve entrapment at the lacertus fibrosus.
  • Symptoms include hand weakness, fatigue, forearm pain, and numbness.
  • Diagnosis can be challenging due to limitations in electromyography (EMG).

Purpose of the Study:

  • To highlight the importance of clinical examination in diagnosing Lacertus syndrome.
  • To review current diagnostic tools and treatment strategies.
  • To emphasize recent advancements in patient care.

Main Methods:

  • Review of clinical examination techniques, including the Hagert clinical triad, lacertus notch sign, and lacertus antagonist test.
  • Discussion of non-operative management approaches.
  • Overview of surgical interventions, including open and ultrasound-guided techniques under wide-awake, local anesthesia, no tourniquet (WALANT).

Main Results:

  • Clinical examination is crucial for accurate diagnosis, overcoming EMG limitations.
  • Non-operative treatments are recommended as a first-line approach.
  • Both open and ultrasound-guided WALANT surgical techniques demonstrate positive patient outcomes.

Conclusions:

  • Improved awareness and accurate clinical diagnosis are vital for managing Lacertus syndrome.
  • Innovative treatments, including WALANT surgery, offer effective solutions.
  • Enhanced diagnostic and therapeutic strategies improve patient care for this condition.