- Anatomy:
-
origin:
- humeral head: medial epicondyle of humerus & common flexion tendon;
- ulnar head: medial side of coronoid process of ulna;
-
insertion: middle 1/3 of lateral surface of radius;
-
synergists:
pronator quadratus;
-
action: pronation of forearm and flexion at the elbow;
-
nerve supply: median,
C7 >
C6 ;
- Pronator Teres Syndrome:
- pts with the pronator teres syndrome have numbness in
median nerve distribution w/
repetitive pronation/supination of the forearm, not flexion and extension of the elbow;
- early fatigue of the forearm muscles is seen with repetitive stressful motion, especially pronation;
- EMG may show only mildly reduced conduction velocities;
- despite their anatomic proximity, pts w/ pronator teres syndrome do not have a higher incidence of
AIN syndrome;
-
other sites of compression:
- ligament of Struthers
- lacertus fibrosis
- pronator teres muscle,
- proximal arch of the
FDS
- rare causes such as following tendon transfers for radial palsy;
-
dissimilarity to CTS
- positive Tinel's in forearm rather than at wrist
- negative phalen's test
- dysesthesia of palmar triangle
- pain on resistance to pronation
- pain in forearm on resistance to isolated flexion of the PIP joint of long and ring fingers;
Transfer of the pronator teres tendon to the tendons of the flexor digitorum profundus in tetraplegia.
The pronator teres syndrome: compressive neuropathy of the median nerve.
Mechanical evaluation of the Pronator Teres rerouting tendon transfer.
