Pronator teres syndrome

　　Pronator teres syndrome is caused by the compression of the median nerve as it passes through the pronator teres or superficial flexor muscle. The patient experiences pain in the proximal forearm, mainly in the pronator teres area. Pain intensifies during resistance pronation.

　　Pronator teres syndrome can be accompanied by joint mobility disorders. Joint mobility disorders refer to varying degrees of impairment of normal joint function (such as flexion, extension, rotation, etc.), manifested as a decrease in the range of joint movement, which is quite different from joint stiffness that results in complete loss of function.

　　The clinical manifestations of pronator teres syndrome include the following types:

　　1. Pain

　　The patient experiences pain in the proximal forearm, mainly in the pronator teres area. Pain intensifies during resistance pronation. The pain can radiate to the elbow, upper arm, or neck and wrist.

　　2. Sensory disorders

　　The radial side of the palm and the radial side of 3 and a half fingers of the patient are numb, but the decrease in sensation is relatively mild. Repeated pronation movements can exacerbate the decrease in sensation.

　　3. Muscle Atrophy

　　The patient's fingers are not flexible, and the pinching strength of the thumb and index finger is weakened. When the thumb and index finger are pinched together, the metacarpophalangeal joint of the thumb and the proximal interphalangeal joint of the index finger are excessively flexed, while the distal interphalangeal joint is excessively extended. The thenar muscle has mild atrophy.

　　The syndrome of the pronator teres is a disease closely related to modern living and working conditions, which can be completely prevented, and the methods of prevention are also very simple. This is to avoid the upper limbs from being in a fixed state for a long time, avoid the upper limbs from being in the same position for a long time, and avoid a mechanical and frequent work state. After working for a period of time, the limbs should be moved and relaxing movements should be done.

　　Patients with the syndrome of the pronator teres should undergo electromyography. In the 7 cases of the syndrome of the pronator teres reported by Morris and Peters, 6 cases showed a decrease in motor conduction velocity. In the 7 cases reported by Buchthal, 3 cases showed abnormal sensory conduction.

　　The diet of the syndrome of the pronator teres should be light, with a high intake of vegetables and fruits such as bananas, strawberries, apples, and foods that enhance immunity to strengthen the body's resistance to diseases. It is also necessary to have a reasonable diet and pay attention to sufficient nutrition. In addition, patients should also avoid smoking and drinking, and avoid spicy, greasy, and cold foods.

　　There are two methods of treatment for the syndrome of the pronator teres:

　　1. Conservative Treatment

　　For cases with intermittent attacks caused by mild to severe upper limb labor after work, conservative treatment can be carried out, including avoiding heavy physical labor, splint fixation, and local封闭treatment with non-hormonal drugs. It is generally believed that for those who cannot improve symptoms and signs after 8 to 10 weeks of conservative treatment, surgical treatment should be considered.

　　2. Surgical Treatment

　　There are many potential compressive factors in the syndrome of the pronator teres. Due to the difficulty of clinical localization, it is advisable to check and release all possible compression points as much as possible during surgery. The elbow is fixed in a flexed position with a plaster cast for 2 weeks after surgery, elevate the affected limb, and encourage the patient to perform finger movements.