Intraoperative immediate strength recovery following lacertus fibrosus release in patients with proximal median nerve compression at the elbow

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dc.contributor.authorAzocar, Camila
dc.contributor.authorCorvalan, Gonzalo
dc.contributor.authorOrellana, Pablo
dc.contributor.authorCobb, Peter
dc.contributor.authorLiendo, Rodrigo
dc.contributor.authorRoman, Javier
dc.date.accessioned2025-01-20T20:08:21Z
dc.date.available2025-01-20T20:08:21Z
dc.date.issued2023
dc.description.abstractPurposeIn the literature, we find that patients with lacertus syndrome (LS), proximal median nerve compression at the elbow, present subjective improvement of thumb, and index flexion strength after lacertus fibrosus (LF) release. The aim of this study is to objectively evaluate the immediate change in intraoperative flexion strength after LF release.MethodWe retrospectively reviewed prospectively collected data of a cohort of 24 patients with a double crush syndrome of the median nerve with no response to conservative treatment. All patients had surgery with LF and carpal tunnel release (CTR) under wide-awake local anaesthesia and no tourniquet (WALANT) and were evaluated intraoperatively with a dynamometer immediately before and after LF release. Flexor digitorum profundus of the second finger (FDP2) and Flexor pollicis longus (FPL) were tested in peak strength to failure. The primary outcome was the percentage of change in strength before and after the release in both assessed muscles. CTR was done after evaluating the change in flexor strength.ResultsA percentage of 79.2 women with an average age of 43.3 years. The average strength of FDP2 before LF release was 15.5 pounds (lbs.) (7.0 kg) (SD, 7.2 lbs (3.3 kg)) and 27.1 lbs. (12.2 kg) (SD, 7.1 lbs. (3.2 kg)) after LF release, which corresponds to a 96% (SD, 70%) change in strength (p=0.000). For FPL, the average pre-release strength was 17.7 lbs. (8.0kg) (SD, 4.8 lbs. (2.2 kg)) and 27.4 lbs. (12.4 kg) (SD, 5.2 lbs. (2.4 kg)) post-release, this corresponded to a 65% (SD, 38%) change in strength (p=0.000).ConclusionsPeak strength to failure in FDP2 and FPL has an immediate significant recovery after LF surgical release in patients with Lacertus syndrome.Level of evidence: IV, retrospective study.
dc.fuente.origenWOS
dc.identifier.doi10.1007/s00264-023-05888-6
dc.identifier.eissn1432-5195
dc.identifier.issn0341-2695
dc.identifier.urihttps://doi.org/10.1007/s00264-023-05888-6
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/91894
dc.identifier.wosidWOS:001040002300001
dc.issue.numero11
dc.language.isoen
dc.pagina.final2786
dc.pagina.inicio2781
dc.revistaInternational orthopaedics
dc.rightsacceso restringido
dc.subjectCompression neuropathy
dc.subjectLacertus fibrosus
dc.subjectHand surgery
dc.subjectLacertus syndrome
dc.subjectMedian nerve entrapment
dc.titleIntraoperative immediate strength recovery following lacertus fibrosus release in patients with proximal median nerve compression at the elbow
dc.typeartículo
dc.volumen47
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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