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Median Nerve Injury at the Elbow
Aka: Median Nerve Injury at the Elbow, Pronator Syndrome
- See Also
- Peripheral Nerve Injury
- Pathophysiology
- Forearm compression of the Median Nerve via the pronator teres muscle
- Differential Diagnosis
- Carpal Tunnel Syndrome
- Symptoms
- Forearm discomfort and ache
- Provoked with elbow extension
- Paresthesias in the thumb, index and middle finger
- Signs
- Sensory loss over thenar eminence (not present in Carpal Tunnel Syndrome)
- Tinel sign absent (contrast with Carpal Tunnel Syndrome)
- Phalen maneuver (contrast with Carpal Tunnel Syndrome)
- Normal Forearm sensation
- Sensation in fingers may also be normal
- Management
- Modify activity
- Consider steroid injection
- Consider brief Splinting with elbow at 90 degrees (risk of loss of elbow range of motion)
- Course
- Anticipate 3-6 month course with therapy
- References
- Neal (2010) Am Fam Physician 81(2): 147-55 [PubMed]