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Median nerve compression in the proximal forearm

W K Olehnik1, P R Manske, J Szerzinski

  • 1Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63110.

The Journal of Hand Surgery
|January 1, 1994
PubMed
Summary

Surgical decompression of the median nerve in the proximal forearm relieved symptoms in most patients, including those with prior carpal tunnel release. This procedure offers an effective treatment for forearm nerve compression.

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Area of Science:

  • Orthopedics
  • Neurology
  • Surgical Procedures

Background:

  • Median nerve compression in the proximal forearm can cause significant forearm and hand symptoms.
  • Previous carpal tunnel release does not preclude successful proximal forearm decompression.

Purpose of the Study:

  • To evaluate the outcomes of surgical decompression of the median nerve in the proximal forearm.
  • To assess the efficacy of this procedure in patients with prior carpal tunnel surgery and workers' compensation claims.

Main Methods:

  • Retrospective review of 39 limbs in 36 patients undergoing proximal forearm median nerve decompression.
  • Analysis of presenting symptoms, physical findings, nerve conduction tests, intraoperative findings, and postoperative outcomes.
  • Subgroup analysis of patients with prior ipsilateral carpal tunnel release.

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Main Results:

  • 30 out of 39 limbs experienced complete or partial symptom relief postoperatively.
  • 14 out of 19 limbs with prior failed carpal tunnel release showed improvement.
  • Common compression sites included the flexor digitorum superficialis tendon and pronator teres muscle.

Conclusions:

  • Surgical decompression of the median nerve in the proximal forearm is an effective treatment for nerve compression.
  • The procedure provides significant relief even in patients with a history of carpal tunnel surgery.
  • Further research may explore predictive factors for optimal outcomes.