Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Pronator Teres Syndrome

SYMPTOMS

There is gradual onset of exercise induced pain around the anterior proximal arm with paraesthesia of the radial three and a half fingers.

AETIOLOGY

This is an injury often affecting the wrist in weightlifters, players in racket sports, javelin throwers and cricket bowlers. It is an entrapment of the median nerve between the two bulks of the pronator teres muscle or in some cases in the fascia between the pronator teres and flexor carpi radialis muscles.

CLINICAL FINDINGS

There is a positive Square test.

INVESTIGATIONS

X-ray and MRI are normal.

TREATMENT

Stretching and correction of technique. Surgical nerve release in severe cases.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon if this diagnosis is suspected or if the diagnosis is not clear. Refer to Dr Kevin Yip, orthopaedic surgeon for consideration of surgery in severe cases.

EXERCISE PRESCRIPTION

Many sports can be maintained. Running, cycling and swimming are good alternatives to keep up general fitness. Gym training can be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs and good elbow function. Compare with other elbow. Square and Benedict’s tests should be negative.

DIFFERENTIAL DIAGNOSES

Radiating pain from the cervical spine (examine the neck).

PROGNOSIS

Excellent, if treated appropriately.

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