The absence of nocturnal paresthesias, and reproduction of the paresthesias with root compression maneuvers. The most proximal median nerve entrapment. The nerve enters the forearm passing between the two heads of the pronator teres and then deep to the arch of the flexor digitorum superficialis, continuing between the flexor digitorum superficialis and flexor digitorum profundus in the forearm. Pain in the proximal forearm, fatigue with exercise, and hand numbness. Pain usually worsens with activity, with numbness and parathesias in hand.
Nocturnal symptoms seen with carpal tunnel syndrome are typically absent.
Negative Phalen's test Weakness of the median innervated muscles is rare. Provocative tests Resisted pronation of the forearm for 30 to 60 seconds demonstrates compression at pronator teres when symptoms are reproduced. Resisted elbow flexion and supination of the forearm can localize compression to the lacertus fibrosis. The supracondylar process can be palpated on the medial humeral surface and confirmed with radiographs. Flexor pollicis longus innervated by anterior interosseus nerve.