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  • Updated 12.29.2020
  • Released 02.02.1998
  • Expires For CME 12.29.2023

Median neuropathy

Introduction

This article includes discussion of median neuropathy, lacertus fibrosus, bicipital aponeurosis, Kiloh-Nevin syndrome, pronator teres syndrome, anterior interosseous syndrome, median entrapment at the bicipital aponeurosis, median entrapment at the ligament of Struthers, and median nerve laceration. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Historical note and terminology

After carpal tunnel syndrome, the most common median nerve entrapment is the pronator teres syndrome (04). Other less common entrapment sites include the ligament of Struthers, lacertus fibrosus, and the tendinous origin of the flexor digitorum superficialis.

Entrapment sites of the median nerve above the wrist
Photograph of upper extremity cadaveric dissection depicting the median nerve course. (A) location of supracondylar process and ligament of Struthers, (B) remnant of severed bicipital aponeurosis, and (C) the pronator teres muscle...

In 1848, Struthers depicted in finer detail the supracondylar process 5 cm above the medial epicondyle and its ligament. Struthers ligament can compress the median nerve (12). Anterior interosseous neuropathy was originally described in 2 patients who had spontaneous recovery (09). Around the same time, the pronator teres syndrome was recognized (23). Median nerve entrapment under the bicipital aponeurosis was described over 2 decades ago (11).

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