The Orthobullets Podcast Hand | Pronator Syndrome
Aug 26, 2025
Dive into the complexities of Pronator Syndrome, a rare condition involving median nerve compression at the elbow. Learn about its distinct symptoms, how it compares to carpal tunnel syndrome, and the latest non-operative management strategies. The discussion also uncovers clinical insights on diagnostic techniques and the effectiveness of surgical interventions under local anesthesia. Misconceptions surrounding alternative treatments for nerve compression are clarified, offering a comprehensive perspective on this intriguing topic.
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Pronator Syndrome Defined
- Pronator syndrome is a compressive neuropathy of the median nerve at the elbow distinct from carpal tunnel syndrome.
- Diagnosis is clinical, with proximal volar forearm pain, palmar cutaneous branch sensory changes, and a positive Tinel sign over the proximal forearm.
Epidemiology And Risk Factors
- Pronator syndrome is rare (<1 per 100,000 annually) and peaks in the fifth decade with female predominance.
- Well-developed forearm muscles, such as in weightlifters, increase risk.
Five Sites Of Entrapment
- Five potential median nerve entrapment sites exist from supracondylar structures to the FDS aponeurotic arch.
- The supracondylar process and ligament of Struthers are important proximal anatomic contributors.