Department of Orthopedic Surgery and Hand Surgery, Centre Hospitalier Interrégional Edith Cavell (CHIREC), Delta, Brussels, Belgium; Centre Hospitalier Universitaire de Bruxelles, Hôpital Erasme, Brussels, Belgium.
Department of Orthopedic Surgery and Hand Surgery, Centre Hospitalier Interrégional Edith Cavell (CHIREC), Delta, Brussels, Belgium.
Hand Surg Rehabil. 2024 Oct;43(5):101775. doi: 10.1016/j.hansur.2024.101775. Epub 2024 Sep 11.
Lacertus syndrome involves dynamic median nerve compression by the lacertus fibrosus, leading to sensory symptoms and loss of strength. Prevalence in the general population is unclear.
This study aimed to determine the prevalence of lacertus syndrome in the Belgian population and to evaluate the effectiveness of the exhaustion test combined with the scratch collapse test.
In a cross-sectional study from May 2023 to February 2024, 362 healthy individuals, aged 18 to 86 years underwent clinical examinations, including the scratch-collapse test and exhaustion test, to assess signs of lacertus syndrome.
11.3% of participants (95% CI: 8.2-15.1%) reported discomfort on lacertus fibrosus palpation. The scratch-collapse test at the lacertus fibrosus was positive in 7.2% of cases (95% CI: 4.8-10.4%), increasing to 25.7% (95% CI: 21.3-30.5%, p < 0.001) following the exhaustion test. There were no significant differences in gender, occupation, or hand dominance (all p > 0.05). Hagert's clinical triad and positive scratch-collapse test over the lacertus fibrosus were found in 2.21% (95% CI: 1.0-4.2%) of this general population after the exhaustion test.
The prevalence of lacertus syndrome was 2.21% after the exhaustion test, and 0.83% before. The exhaustion test led to significant conversion of negative to positive scratch-collapse test from 7.2% to 25.7%. The exhaustion test enhanced the scratch-collapse test's diagnostic accuracy, revealing a spectrum of lacertus syndrome symptoms, from unnoticed mild cases to severe manifestations, and confirmed the importance of Hagert's clinical triad in diagnosing lacertus syndrome.
纤维索带综合征是由纤维索带对正中神经的动态压迫引起的，导致感觉症状和力量丧失。其在普通人群中的患病率尚不清楚。
本研究旨在确定比利时人群中纤维索带综合征的患病率，并评估疲劳试验联合划痕塌陷试验的有效性。
在 2023 年 5 月至 2024 年 2 月进行的横断面研究中，对 362 名 18 至 86 岁的健康个体进行了临床检查，包括划痕塌陷试验和疲劳试验，以评估纤维索带综合征的征象。
11.3%（95%CI：8.2-15.1%）的参与者在触诊纤维索带时报告不适。在 7.2%（95%CI：4.8-10.4%）的病例中，划痕塌陷试验在纤维索带处呈阳性，在进行疲劳试验后增加到 25.7%（95%CI：21.3-30.5%，p<0.001）。性别、职业或手优势（均 p>0.05）之间无显著差异。在疲劳试验后，Hagert 三联征和纤维索带上方的划痕塌陷试验阳性在普通人群中占 2.21%（95%CI：1.0-4.2%）。
疲劳试验后纤维索带综合征的患病率为 2.21%，疲劳试验前为 0.83%。疲劳试验使划痕塌陷试验从 7.2%转为 25.7%，显著提高了阴性转为阳性的转化率。疲劳试验增强了划痕塌陷试验的诊断准确性，揭示了纤维索带综合征从无症状的轻度病例到严重表现的一系列症状，并证实了 Hagert 三联征在诊断纤维索带综合征中的重要性。
