PRONATOR SYNDROME

Classic Presentationpronator_teres_syndrome.jpg

The patient complains of forearm pain.  There is usually no history of trauma; however, there is often a history repetetive pronation (rotating forearm from palms up to palms down) and wrist flexion such as incurred by carpenters, assembly line workers, and weight lifters.

Cause

Compression may occur at several sites, including the bicipital aponeurosis that connects with the pronator teres muscle, between the two heads of the pronator teres muscle, and at the flexor digitorum superficialis muscle by a thickened, fibrotic arch.  Compression between the two heads of the pronator is often due to hypertrophy (increased muscle size).  Other (rarer) sites are beneath the ligament of Struther's, the median artery, and a bicipital tuberosity bursa.

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