# Pronator Teres and median nerve release



## Amzie (May 29, 2015)

Hello everyone, 
I need some assistance on coding this op report. Any suggestions and references would be wonderful!
I was thinking for the median nerve 64708 and for the pronator teres 64772??
but when I did some research on this I keep finding articles that the pronator teres is part of the median nerve??

Lt arm pronator teres release and proximal median nerve release

I began with a lazy S incision in the proximal forearm. Incised the skin and subcutaneous tissue. I then began to identify the radial neurovascular structure in the distal portion of the incision. In between the radial neurovascular structure and the radial sensory nerve I developed an interval to identify the superficial portion of the protator teres tendon. A step cut lengthening was then performed sharply. This allowed for decompression of the pronator teres. Next I proceeded to dissect proximally, and then applied the fibers of lacertus aponeurosis and those fibers were released.I then identified the proximal radial neurovascular structure on the medial aspect, and began to dissect deeply to identify the median nerve. The median nerve was identified and tied with a suture. I identified the deep head of the pronator teres which was transvering the median nerve. This head as carefully dissected and excisied to decompress the nerve.There was evidence of an hourglass lesion proximal to where the AIN branch occurred and proximal to the hourglasss there was an increased diameter of the median nerve suggesting compressive lesion.. I continued my dissection distally and there was proximal leading edge of the FDS fascial band that was also released because it was tight.


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