Ultrasound Guided Hand Surgery Center, 2 Rue de Tocqueville, 78000 Versailles, France; Private Hospital Les Franciscaines, 7 Route de la Porte de Buc, 78000 Versailles, France.
Orthopedic Group Ormeau Pyrénées, Polyclinique de l'Ormeau, Tarbes, France.
Hand Surg Rehabil. 2024 Sep;43(4):101738. doi: 10.1016/j.hansur.2024.101738. Epub 2024 Jun 7.
Lacertus syndrome consists in proximal median nerve entrapment with median nerve compression at the lacertus fibrosus, causing hand weakness and fatigue, forearm pain and occasional numbness. Recent advances emphasized the importance of clinical examination, due to limitations in electromyographic diagnosis and delayed diagnosis. The Hagert clinical triad, lacertus notch sign, lacertus antagonist test and taping help accurate diagnosis. Non-operative treatment should be tried; and surgical techniques, whether open or ultrasound-guided under WALANT (wide-awake, local anesthesia, no tourniquet) show promising outcomes. Improved awareness, accurate diagnosis and innovative treatments enhance patient care for this challenging condition.
拉克塔斯综合征表现为正中神经在纤维弓处受到近端压迫，导致手部无力和疲劳、前臂疼痛和偶尔麻木。由于肌电图诊断的局限性和诊断延迟，近期研究强调了临床检查的重要性。Hagert 三联征、纤维弓切迹征、纤维弓拮抗试验和贴扎有助于准确诊断。应尝试非手术治疗；手术技术，无论是开放式还是 WALANT（清醒、局部麻醉、无止血带）引导下的超声技术，都显示出有前途的结果。提高认识、准确诊断和创新治疗方法可改善患者对这种具有挑战性疾病的护理。
