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Dual Oblique Incisions for Release of the Proximal Median Nerve
William B. Ericson, MD
Ericson Hand and Nerve Center, Mountlake Terrace , WA

Proximal median nerve entrapment (aka Pronator Syndrome) is a challenging diagnosis for many reasons: inherently vague complaints, subtle physical exam findings that are not well-described, electrodiagnostic tests are unreliable to confirm the diagnosis, and the results of surgery can be unpredictable. The anatomy around the proximal median nerve adds to the complexity of both the diagnosis and treatment, as there are multiple anatomic features in region of the elbow with the potential to cause compression of the median nerve. It has been recommended that surgical decompression of the proximal median nerve, if considered, address each possible area of compression. Large incisions about the elbow permit full visualization of pertinent anatomy, but can cause seriously disfiguring scars. This paper describes the use of two small incisions which allow safe visualization of the entire proximal median nerve, with cosmetically acceptable scars. Operative time is short, and no postoperative cast, splint or therapy is necessary.


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