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Brachial artery compression by the lacertus fibrosus
F H Bassett1, R J Spinner, T A Schroeter
1Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710.
Clinical Orthopaedics and Related Research
|October 1, 1994
Summary
Athletes with forearm hypertrophy can experience brachial artery compression from the lacertus fibrosus, causing intermittent claudication. Surgical release of this band effectively restored arterial pulses and improved symptoms in all patients.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Sports Medicine
Background:
- Intermittent claudication in athletes can stem from various causes.
- The lacertus fibrosus is a known cause of neural compression and compartment syndrome.
- Isolated arterial compromise due to the lacertus fibrosus is rarely reported.
Purpose of the Study:
- To investigate brachial artery compression by the lacertus fibrosus in athletes.
- To describe the clinical presentation and diagnostic findings.
- To evaluate the efficacy of surgical intervention.
Main Methods:
- Case series of five athletes presenting with claudication symptoms.
- Clinical examination including assessment of radial pulse with specific maneuvers (forearm pronation, resisted elbow flexion).
- Diagnosis of brachial artery compression by the lacertus fibrosus.
Main Results:
- All patients were athletes with hypertrophied forearm muscles.
- Physical examination revealed localized tenderness and obliterated radial pulse with specific movements.
- Surgical release of the lacertus fibrosus restored normal pulses in all five patients.
- Three patients achieved full clinical recovery, one had a good result, and one had a fair result.
Conclusions:
- Hypertrophied lacertus fibrosus can cause brachial artery compression and intermittent claudication in athletes.
- Surgical release of the lacertus fibrosus is an effective treatment for this condition.
- Muscle hypertrophy from overuse is a significant factor in developing these neurovascular lesions.