Shahzada M Hassan Jafri, Khawaja S A, Taj R U.
Pronator Teres Syndrome (PTS).
Ann King Edward Med Uni Jan ;8(2):138-9.

PTS is not a common syndrome, very less reports of this syndrome is present in the literature. In PTS, pain affects the function of hands. We report a case of PTS as the first case reported in the literature of Pakistan.

Case Report: A 35 years old patient reported in the Outpatient Department, Hand Upper Limb Surgery Centre with pain on the flexor aspect of forearm more near the elbow joint radiating distally. Pain increases on heavy physical work. On examination there was wasting of thenar muscles. Anesthesia over the thenar eminence, on the lateral aspect of the thumb and index finger noted. Patient was unable to make a fist as the thumb index and middle finger remained semi flexed. Loss of opposition of the thumb was also present. Before coming to Hand Upper Limb Surgery Centre, the patient was given NSAIDS, ILCS (kenacort) and physiotherapy. Nevertheless, pain kept on increasing and resulting into anaesthesia in portion of hand already mentioned. At surgery, thick fibrous arch between the two heads of pronator teres was found. This arch was compressing the median nerve in the pronator teres compartment. Compression by the fibrous arch made an indentation on the median nerve. Fibrous arch divided and epineurectomy of involved nerve portion was done. One month post operatively patient regained motor post operatively patient regained motor function of the hand, index and the middle fingers. Are of anaesthesia (grade 5) improved to grade 2, patient is likely to improve.

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