The superficial radial sensory nerve can be entrapped between the brachioradialis and extensor carpi radialis longus tendons as the radial sensory nerve courses superficially from its deep origin. Compression of the radial sensory nerve presents with numbness and/or pain on the dorsal radial aspect of the hand. Pronation of the hand exacerbates these symptoms as […]
Entrapment of the common peroneal nerve (CPN) at the fibular head is an under-recognized lower extremity neuropathy that contributes to weakness of the musculature within the anterior and lateral compartments of the leg and progress to foot drop. As well, there can be numbness/pain within the territory of the superficial and deep peroneal nerve. Compression […]
Compression of the superficial peroneal nerve (SPN) is due to the superficial fascial layer that encapsulates the SPN and its distal entrapment point called the transverse crural ligament. These structures are typically the cause for numbness and pain in the territory of the SPN. Release of the SPN involves the longitudinal release of the superficial […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation discusses carpal tunnel syndrome (CTS) and median neuropathy in the context of compression neuropathies. In particular, this presentation details the specific nuances for (1) an open carpal tunnel release, (2) revision carpal […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation discusses cubital tunnel syndrome (CTS) and ulnar neuropathy in the context of compression neuropathies. In particular, this presentation details several topics that includes (1) controversy of management for CTS, (2) patient evaluation, […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. This presentation discusses thoracic outlet syndrome (TOS) in the context of compression neuropathies. In particular, this presentation details conservation management of TOS and the pathogenesis of cumulative trauma disorder. Additionally, a case presentation for […]
Entrapment of the saphenous nerve is probably under-recognized and presents with numbness/pain in the infrapatellar region and the medial aspect of the lower leg. The vastoadductor intermuscular septum is responsible for entrapment symptoms as it forms the anterior fascia of the adductor canal, deep to the sartorius muscle. The femoral vessels and saphenous nerve have […]
Radial nerve compression at the level of the humerus is uncommon and occurs at the spiral groove. The radial nerve has an anatomical course proximal below the lateral intermuscular septum and continues distal between the brachialis and brachioradialis muscles. The entrapment point involves the tendinous lateral intermuscular septum and provocative tests will be positive at […]
Failure to resolve symptoms of carpal tunnel syndrome following a release of the flexor retinaculum can occur for a number of reasons. Failed carpal tunnel can be classified into three categories and include (1) persistent symptoms, (2) recurrent symptoms, and (3) new symptoms. Persistent symptoms of median nerve dysfunction can imply an incomplete release and/or […]
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication. Complications following carpal tunnel release are uncommon with patients experiencing persistent, recurrent, or new symptoms in the post-operative period. There are multiple etiologies for recurrent carpal tunnel syndrome, which can include traction neuropathy. This […]
Compression of the posterior interosseous nerve can exhibit clinical weakness or functional loss of finger / thumb extension and lack of ulnar wrist extension. Provocative tests can confirm whether the radial tunnel in the region of the posterior interosseous nerve is the area of compression. Multiple anatomical structures can be involved in compressing the nerve […]
Compression neuropathy of the median nerve in the forearm, also known as pronator syndrome, typically presents with pain in the forearm +/- paresthesia/pain in the median nerve territory. The anterior interosseous nerve can be involved with a mononeuritis. While this usually resolves without surgery, occasionally will require this approach for reconstruction or release. Related anatomical […]
Carpal tunnel syndrome is a compression neuropathy of the median nerve as it travels through the carpal tunnel deep to the transverse carpal ligament. This causes paresthesia and pain in the territory of the median nerve and weakness of the thenar muscles depending on the severity of the neuropathy. Paresthesia is most typically in the […]
Tarsal tunnel syndrome describes the compression of the tibial nerve through the tarsal tunnel which results in pain and numbness in the plantar aspect of the foot. The tibial nerve has three major branches which include the calcaneal, medial plantar, and lateral plantar nerve branches. There are two primary structures responsible for compression of the […]
Symptoms of a compressed superficial peroneal nerve in the lower leg includes numbness and tingling in the dorsal aspect of the foot and lateral aspect of the lower leg. These symptoms can be exaggerated when the peroneal nerve is under tension during movements of the leg and foot. Compression of the superficial peroneal nerve occurs […]
Compression of the common peroneal nerve at the fibular head is under recognized. Symptoms range from numbness and tingling in the posterior and lateral aspect of the lower leg and dorsal aspect of the foot to foot drop in severe cases of denervation. Symptoms can be exaggerated when the peroneal nerve is under tension during […]
Neurological thoracic outlet ‘inlet’ syndrome (TOS) involves compression of the brachial plexus through the thoracic inlet. The neurologic symptoms of TOS can range from mild paresthesias and numbness in the upper extremity to intrinsic hand muscle atrophy. Thoracic outlet decompression entails decompressing the upper, middle, and lower trunks by dividing the anterior and middle scalene […]
A submuscular ulnar nerve transposition is performed to decompress the ulnar nerve in the cubital tunnel at the elbow. The medial antebrachial cutaneous nerve is identified and protected. Proximally, the medial intermuscular septum is resected. A step-lengthening of the fascia of the flexor-pronator muscles is performed. The ulnar nerve is placed in a transmuscular location. […]
A carpal tunnel release is performed by decompressing the median nerve in the wrist through the carpal tunnel. This procedure involves transecting the transverse carpal ligament. Standard: POSITION Supine. INCISION An incision is made ulnar to the thenar crease between the palmar sensory territories of the median and ulnar nerve. In addition, this approach allows […]
The median nerve is decompressed in the forearm. A Z-plasty lengthening is performed on the pronator teres tendon. In addition, the tendon of the deep head of the pronator teres is transected and the flexor digitorum superficialis tendinous arch is released. Standard: Extended: POSITION Supine. INCISION A lazy-S incision is made over the proximal forearm. […]
The ulnar nerve is decompressed in the wrist through Guyon’s canal and in the hand, specifically the deep motor branch of the ulnar nerve. This deep motor branch is released by dividing the tendious arch of the hypothenar muscles. In addition, a carpal tunnel release is performed by transecting the transverse carpal ligament. Standard: Extended: […]