Lacertus Syndrome

Overview

Lacertus syndrome occurs when the median nerve becomes compressed near the elbow, beneath a band of tissue called the lacertus fibrosus. It’s an under-recognised condition that shares some features with carpal tunnel syndrome, particularly weakness in the hand, but tends to cause more forearm pain, fatigue and a sense of clumsiness rather than the classic nighttime tingling seen in carpal tunnel syndrome. It’s sometimes identified in patients who have had carpal tunnel treatment without full relief of their symptoms. Ms Anna Moon has a particular interest in identifying and treating this less commonly diagnosed nerve compression.

What is the Treatments

Detailed clinical examination, including specific nerve provocation tests
Activity modification and nerve gliding exercises
Corticosteroid injection to reduce nerve irritation
Ultrasound imaging to help confirm the diagnosis
Minimally invasive surgical release of the lacertus fibrosus for persistent cases

The Procedure

Lacertus syndrome can be difficult to diagnose, as standard nerve conduction studies don’t always detect it reliably, so diagnosis relies heavily on clinical examination and specific tests for tenderness and weakness along the nerve’s path. Initial treatment often includes activity changes, nerve gliding exercises, or a corticosteroid injection. Where symptoms persist, a minimally invasive procedure to release the lacertus fibrosus and relieve pressure on the nerve may be recommended, often performed as a day case under local anaesthetic.

Recovery & Aftercare

Many patients notice improvement in strength and reduced pain following surgical release, sometimes fairly soon after the procedure, though full recovery of hand endurance can take longer. Ms Anna Moon provides guidance on gradual return to activity and arranges follow-up review to monitor progress.

Frequently Asked Questions

What is Lacertus syndrome?

Lacertus syndrome is compression of the median nerve near the elbow, beneath a band of tissue called the lacertus fibrosus, causing hand weakness, fatigue and forearm pain.

How is Lacertus syndrome different from carpal tunnel syndrome?

Lacertus syndrome tends to cause more hand weakness, fatigue and forearm pain, with less of the classic nighttime tingling associated with carpal tunnel syndrome, and the compression occurs higher up, near the elbow.

Why is Lacertus syndrome sometimes missed?

Standard nerve conduction studies don’t always detect this type of compression reliably, so it can be overlooked or mistaken for other conditions such as carpal tunnel syndrome or tennis elbow.

Can Lacertus syndrome be treated without surgery?

Milder cases may improve with activity changes, nerve gliding exercises or an injection. Surgery is generally considered when symptoms are more persistent or significantly affect hand function.

Overview

What is the Treatments

The Procedure

Recovery & Aftercare

Frequently Asked Questions

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Anna Moon

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