Median nerve compression

location of compression
1. medial intermuscular septum
2. ligament of struthers
3. bicipital aponeurosis
4. pronator
5. arch of FDS (anterior interosseus syndrome)
6. Carpal Tunnel
Pronator: vague ache : NB no nocturnal symptoms, numb Palmar cutaneous branch
: tender / firm over pronator
: resisted pronation of [...]

Ulnar nerve compression

NB DDX = parsonage-turner syndrome, cervical radiculopathy
sites of compression
intermuscular septum – arcade of struthers, medial septum, medial triceps (snapping)
medial epicondyle
epicondylar groove – cubital tunnel (osborne’s ligament)
between humeral and ulnar head of FCU
Flexor Pronator Aponeurosis
Guyon’s Canal
– zone 1 – prox. to bifurcation = most common (@ hook of hamate)
– zone 2 – [...]

Radial nerve compession

High radial – saturday night palsy, compression by lateral head triceps, anomalous muscle, +/- triceps involvement.
DDx – brachial neuritis, peripheral neuropathy, cervical radiculopathy, thoracic outlet
radial tunnel – sensory, no weakness, d/t intermittent compression
: “persistent tennis elbow”
: night pain > post activity pain
: tender over radial tunnel > [...]

Missed Monteggia

6/12 : need to osteotomize ulna or radius –> consensus is ulna is easier – can osteotomize at apex.
1. Reduce Ulna +/- Internal Fixation
2. Expose Radius : do boyd-anderson instead of kocher (lift anconeus up off ulna)
3. harvest strip of triceps (lateral 1/3)
4. release annular ligament and scar
5. drill hole in ulna & pass triceps [...]