Compression neuropathies in the anterior forearm.

In nerve entrapment syndromes in the upper extremity, the surgeon must first become a diagnostician. When the symptoms of entrapment are bilateral, diabetes mellitus and cervical arthritis are found in a significant statistical number over the general population. These diseases can result in incomplete relief of symptoms, even after decompression of the entrapment. In Upton's double crush theory, proximal nerve impingement can cause increasing symptoms distally and this can account for some failures following carpal tunnel surgery. Bilateral carpal tunnel patients are often predisposed by anatomically small carpal tunnel canals, cervical arthritis, or diabetes mellitus. Usually, with a precise diagnosis and a careful treatment plan, excellent results can be achieved with removal of the anatomic constriction or mechanical block.