Median nerve compression: Pronator and anterior interosseous syndromes

Proximal compression or neuropathy of the median nerve is rare compared with carpal tunnel syndrome but recognition and management of these conditions is important. Pronator syndrome refers to compression of the median nerve around the elbow, which may present with pain in the forearm and paraesthesia in the hand. Anterior interosseous syndrome (palsy) can result from mechanical compression or inflammatory neuropathy causing significant impairment of dexterity in the hand. Clinical features and the place of neurophysiological testing are discussed. Surgical decompression is indicated when mechanical compression is suspected.