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The pronator compression test revisited. A forgotten physical sign.

Pronator compression testing is a valuable clinical feature of median nerve entrapment diagnosis. Of 10 patients with this disorder, all developed paresthesias preoperatively in the hand after 30 seconds or less of manual compression of the median nerve at or near the pronator muscle. Eight patients had a positive Tinel's sign at the impingement site, but only one patient had a positive electromyographic result. More than 50% of the patients had undergone previous carpal tunnel release or were diagnosed at presentation with double crush syndrome. All patients had a good or excellent result from surgical decompression of the median nerve in the forearm, except for one workers' compensation case who had excellent postoperative strength testing but multiple residual complaints. Pronator compression testing is a helpful and dependable physical sign in the diagnosis of pronator syndrome.