Outcome of Surgical Treated Isolated Pronator Teres Syndromes-A Retrospective Cohort Study and Complete Review of the Literature.

Harald Binder,Micha Komjati,Domenik Popp,Thomas M Tiefenboeck,Armin Zadra

doi:10.3390/ijerph19010080

Abstract

Purpose: This study aims to elucidate the occurrence of postoperative carpal tunnel syndrome (CTS), the functional outcome of patients with primary pronator teres syndrome (PTS), and review complete literature regarding this topic. Material and Methods: A retrospective chart review was conducted in patients with PTS at a single center. In all patients, a numeric Visual Analog Scale (VAS) score, Pinch-Test, Jamar hand dynamometer test (JAMAR), and the Disabilities of the Arm Shoulder and Hand (DASH) score were analyzed preoperatively and at final follow-up to assess outcome. Additionally, a complete review of the literature was performed, including all data dealing with pronator teres syndrome. Results: Ten female and two male patients were included with a mean age of 49 years. Significant improvement in DASH and numeric VAS was detected at latest postoperative follow-up. In three patients, clinical signs of CTS pathology were detected during the follow-up period. One patient needed to be treated surgically, and in the other two patients, a conservative management was possible. In one patient (8%), a PTS recurrence was detected. All patients presented satisfied at latest follow-up. Conclusion: In one-fourth of our patients, a CTS occurred during the follow-up period. Therefore, focusing on double-crush syndrome in unclear or mixed symptoms is necessary to avoid multiple operations. Furthermore, it seems that assessment with NCV is not enough for diagnosing PTS; therefore, further research is needed to clarify this problem.

Highlights

Publisher’s Note: MDPI stays neutralThe pronator teres syndrome (PTS), first described by Seyfarth in 1951 as a representative proximal forearm median neuropathy [1], is a very rare and rather difficult to assess pathologically
This study aims to elucidate the occurrence of postoperative carpal tunnel syndrome (CTS) and the functional outcome of this patient collective
A retrospective chart review was conducted in patients with PTS treated between 2005 and 2017 in a single-center institution

Summary

Introduction

The pronator teres syndrome (PTS), first described by Seyfarth in 1951 as a representative proximal forearm median neuropathy [1], is a very rare and rather difficult to assess pathologically. The cause of compression in the pronator canal is muscle hypertrophy due to excessive overloading or trauma with resulting hematoma or even deformity [2,3,4]. It is associated with the presence of variable anatomical structures at the starting point with regard to jurisdictional claims in published maps and institutional affiliations

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