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Exceptional Patient No.7

CC had surgery for carpal tunnel compression in both hands a few years ago by another surgeon. Her symptoms disappeared completely after the surgery.

A few years later, she started having neuropathic pain again, but it was different from what she had before. She had no pain at night, and the numbness and throbbing she had were going up her forearms. She also had a loss of strength and was very clumsy with both hands. She went to see her family doctor who ordered an EMG.

With the results of the EMG passed at the level of her wrists, the doctor recommended a repeat carpal tunnel decompression surgery on both wrists again. Discouraged and unsure, the patient consulted with Exception MD. Taking the time to listen to her complaints and rigorously evaluating both upper limbs, Dr. Brutus diagnosed CC with lacertus syndrome in both arms, while the provocative tests for the carpal tunnel were negative, suggesting that the previous decompressions were successful.

Lacertus syndrome is, in fact, a compression of the same nerve that is compressed by the carpal tunnel, but it is compressed higher, at the elbow. CC decided to go ahead with lacertus decompression surgery on both elbows. During the 30-minute surgery, Dr. Brutus was able to test and feel the return of active strength in both of CC’s hands.

10 minutes after the operation, CC sits in the office so that her strength can be objectively re-evaluated immediately post-op. Here is the calculated improvement: a 29% increase in her right hand and a 60% increase in her left hand while she is still under local anesthesia. Not only that, but CC reports that the numbness has already diminished, and the throbbing sensation has already disappeared in both her forearms.

"The first doctor recommended redoing the two carpal tunnel surgeries, but I felt there was something different. Searching the internet, I found that I had lacertus syndrome. I then went to see Dr. Brutus, who confirmed to me that I no longer had a carpal tunnel problem but that it was higher up, in both elbows. If I hadn't listened to myself, I would have had another operation for nothing. Dr. Brutus explained to me that the EMG did not detect the lacertus syndrome... After my surgery on both elbows, I recovered very quickly. THANKS."

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