Consultant hand surgeon · Wide-awake local anaesthetic · Day case

Lacertus syndrome surgery in Cardiff

Weak pinch grip, forearm ache, or carpal tunnel symptoms that never went away? Lacertus syndrome release under wide-awake local anaesthetic with consultant hand surgeon Mr Alistair Phillips.

Rated excellent on Google

By our patients

HIW registered

Healthcare Inspectorate Wales

Senior, named clinicians

GMC and NMC registered

Award-winning clinic

Best Private Medical Clinic, Wales

At a glance

Surgery fee

£2,050 all-inclusive

Procedure time

About 15 to 20 minutes

Anaesthetic

Local (WALANT), you stay awake

Back to light use

Within a few days

First step

Free video consultation

Lacertus syndrome release in Cardiff

Lacertus syndrome is compression of the median nerve just below the elbow, where the nerve passes under a tight band of tissue called the lacertus fibrosus. It is often missed, or mistaken for carpal tunnel syndrome, because it affects the same nerve.

Lacertus release is a short operation to divide this band and free the nerve. At Excel Clinic it is done by consultant hand surgeon Mr Alistair Phillips under WALANT (wide awake local anaesthetic, no tourniquet). Because you are awake, he can check the strength of your hand during the operation. There is no overnight stay and no GP referral is needed.

Medically reviewed by Mr Alistair Phillips, MBBS FRCS (Tr & Orth), consultant hand, wrist and elbow surgeon (GMC 4718495). Last updated November 2026.

What is lacertus syndrome?

The median nerve runs down the front of the arm. Just below the elbow crease it passes beneath the lacertus fibrosus, a band of tissue that fans out from the biceps tendon into the forearm. In some people this band squeezes the nerve, especially with repeated gripping and twisting of the forearm.

Unlike carpal tunnel syndrome, the main problem is usually weakness rather than numbness. The muscles that bend the thumb and index finger and flex the wrist become weak, so pinch grip, writing and opening jars get harder. Nerve conduction studies are often normal, which is one reason the condition is easily missed. Diagnosis relies on careful examination by a hand surgeon who knows what to look for.

Risk factors

Repetitive gripping and twisting of the forearm
Manual work, weight training and racquet sports
Musicians and people who use tools for long periods
A naturally tight lacertus band
It can occur alongside carpal tunnel syndrome

Symptoms

Weak pinch grip between the thumb and index finger
Difficulty writing, opening jars or turning keys
Aching in the front of the forearm, worse with use
The hand and forearm tiring quickly during repetitive tasks
Sometimes pins and needles in the thumb and fingers
Hand symptoms that continue after carpal tunnel surgery

Could it be lacertus syndrome?

Mr Phillips may suspect lacertus syndrome if you have:

Weak thumb and index finger

Weakness bending the tip of the thumb or index finger, or flexing the wrist, found on examination.

Symptoms after carpal tunnel surgery

Hand weakness or pain that did not improve after a carpal tunnel release.

Normal nerve tests

Nerve conduction studies that are normal or near normal despite clear symptoms.

Treatment options

Mild symptoms sometimes settle with rest and activity changes. Surgery is offered when weakness or pain persists.

Rest and activity changes

Reducing repetitive gripping and forearm twisting can ease mild symptoms.

Hand therapy

Stretches and advice from a hand therapist help some people.

Lacertus release

A short wide-awake operation to divide the tight band and free the median nerve.

Your surgeon

Consultant Hand, Wrist & Elbow Surgeon

Mr Alistair Phillips

MBBS FRCS (Tr & Orth) · GMC 4718495

Mr Phillips is a consultant hand, wrist and elbow surgeon in private practice in Winchester and London, and now operates at Excel Clinic in Cardiff. He holds a Visiting Academic Fellowship at the University of Southampton and sits on the Council of the Association of Surgeons in Primary Care.

He specialises in hand surgery under local anaesthetic, with the patient awake and no tourniquet (WALANT). He co-authored the standard textbook on the technique and the BSSH/GIRFT White Paper on hand surgery outside main operating theatres, and was an early adopter of ultrasound-guided carpal tunnel release.

At Excel Clinic he performs cubital tunnel release, lacertus syndrome release and Dupuytren’s treatment, as well as ultrasound-guided carpal tunnel and trigger finger release.

What our patients say

    
 
 
       Posted on Google  
   
   Suzanne Edgell 
 18/09/2026
 
 
 Trustindex verifies that the original source of the review is Google. Outstanding experience from start to finish!recently visited Excel clinic for an upper blepharoplasty, and i cannot praise the team enough.From the welcoming reception staff to Mr Abu Feroz and his medical team ,the care was exceptional.I was made to feel incredibly comfortable and reassured throughout the whole process .The follow-up care-including my stitch removal and the recent check-up to access my healing -was handled with the utmost professionalism highly satisfied and strongly recommend Dr Abu and his team.
  
 
      Posted on Google  
   
   Katrin Cross 
 16/09/2026
 
 
 Trustindex verifies that the original source of the review is Google. Really happy. Price, availability, communication, and overall experience all fantastic.
  
 
      Posted on Google  
   
   Tyrone Jones 
 28/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. Brilliant service, well looked after from moment you walk through door,lovely people and so professional.
  
 
      Posted on Google  
   
   Catherine Sutherland 
 28/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. I am very happy with the results of my cyst removal by Dr Feroz. It was on my face so, scarring was a concern and even right after the stitches were removed, there was only a bit of redness.  Now, a few months later, it's not noticeable. They kept to the schedule so, no hanging about waiting at all. There was a bit of a mix up with my first appointment but, these things happen and it was resolved quickly.
  
 
      Posted on Google  
   
   Sarah Seymour 
 27/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. Very good service for my Mum. Efficient and staff were very friendly.
  
 
      Posted on Google  
   
   Luke Callen 
 17/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. Contacted Excel for a double earlobe reduction. The price was very reasonable The service was fast/efficient and the staff were welcoming and reassuring throughout.
  
 
      Posted on Google  
   
   Amel K B 
 14/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. Exceptional medical care !
I had a procedure just six days ago at Excel Clinic to remove a cyst from my back and a mole from my nose. Although my stitches are yet to be removed, I already want to highlight the remarkable quality of care I received. The surgery was very quick, and I experienced no pain at all.
From arrival to departure, there is absolutely nothing to fault: I was even personally welcomed by members of the management team. The professionalism of the entire staff is faultless, and the cleanliness of both the clinic and the operating room is simply sparkling.
I particularly appreciated the thoroughness of their process: the health questionnaire I had completed online was reviewed face-to-face with the surgeon beforehand. He was very attentive, took the time to explain every step clearly, and provided great advice before heading into surgery. The nurse assisting him was equally professional and skilled.
Having had some initial hesitation, I am now very glad I went through with it. This is a thoroughly reliable clinic, and certainly one to consider in Cardiff for any procedures within their field of expertise.
  
 
      Posted on Google  
   
   francesca evans 
 14/08/2026
 
 
 Trustindex verifies that the original source of the review is Google. I am 2 days post op from a lower bleph. Dr Feroz and his team were so lovely and helpful from the moment I stepped in there. The surgery was explained thoroughly and I felt at ease. The healing process so far is great! Not as painful as I thought it would be!
Thanks again Team Excel x

What happens during surgery

Local anaesthetic is injected just below the elbow crease. You stay awake and comfortable, with no tourniquet.
A small incision is made in the crease at the front of the elbow.
The lacertus fibrosus is divided to release the pressure on the median nerve.
With you awake, Mr Phillips checks the strength of your thumb, index finger and wrist. The skin is then closed and a light dressing is applied.

The operation takes around 15 to 20 minutes and you go home the same day. You cannot drive yourself home, so please arrange a lift.

Your lacertus syndrome journey, step by step

Send your booking form

Free video consultation

Consultation with Mr Phillips

Your procedure

Recovery and aftercare

Follow-up

Tap each step for more detail.

1. Send your booking form

Complete the short form at the bottom of this page and tell us about your symptoms and any treatment you have already had.

2. Free video consultation

A free 15-minute video call to talk through your symptoms and whether treatment is the right next step.

3. Consultation with Mr Phillips

An in-person consultation with Mr Phillips (£250) to examine you and confirm the diagnosis. Have your consultation and surgery on the same day (a one-stop appointment) and the consultation is included in the package.

4. Your procedure

Walk in, walk out. The release is done under wide-awake local anaesthetic in our theatre at Cardiff Gate and takes around 15 to 20 minutes.

5. Recovery and aftercare

You go home with clear written aftercare instructions and WhatsApp access to our team if you have any questions.

6. Follow-up

A follow-up review is included to check your wound and your recovery.

Recovery timeline

After lacertus release

Same day

Light use of the hand is encouraged straight away.

First week

Keep the dressing clean and dry. Most people manage everyday tasks and desk work within a few days.

Around 2 weeks

Wound check. Stitches are removed or dissolve.

2–4 weeks

Driving, heavier lifting and gym work are reintroduced gradually.

Many people notice their grip feels stronger soon after the release. Ache and fatigue in the forearm can take a few weeks to settle.

Results and risks

What to expect

Many people notice their pinch and grip strength improve soon after the band is released, sometimes while still on the operating table. Forearm ache usually settles over the following weeks.

Possible risks

Possible risks include infection, bruising, a tender scar at the elbow crease, numbness of the skin of the forearm and, rarely, nerve or blood vessel injury or symptoms persisting. Mr Phillips will go through these with you.

Long-term outlook

Lacertus release is intended as a permanent solution. If you also have carpal tunnel syndrome, Mr Phillips will advise whether to treat both.

Excel Clinic compared with NHS treatment

	Excel Clinic	NHS treatment
Waiting time	Usually 2–4 weeks	Often many months
GP referral	Not needed	Required
Assessment	Consultant hand surgeon experienced in lacertus syndrome	Can be missed, as nerve tests are often normal
Anaesthetic	Wide awake local anaesthetic (WALANT)	Varies
Aftercare	WhatsApp access to our team	Standard follow-up
Cost	£2,050, fixed price	Free

Tip: scroll sideways to see the full table on a phone.

Lacertus syndrome surgery cost in Cardiff

Treatment	Fee
Video consultation Free 15-minute video consultation	Free
In-person consultation with Mr Phillips Included in the package with a one-stop appointment	£250
Lacertus syndrome release Includes anaesthetic, surgery, aftercare and follow-up	£2,050
Follow-up review	Included

Fixed, all-inclusive prices with no hidden costs. Have your consultation and surgery on the same day (a one-stop appointment) and the consultation is included in the package.

Why choose Excel Clinic?

Specialist hand surgeon

Mr Alistair Phillips, consultant hand, wrist and elbow surgeon and co-author of the standard textbook on wide-awake hand surgery.

Wide-awake surgery

Local anaesthetic with no tourniquet, no general anaesthetic and no overnight stay.

Fixed, transparent prices

One all-inclusive fee covering the procedure, anaesthetic, aftercare and follow-up.

Easy to reach

Designated patient parking, just off Junction 30 of the M4.

Frequently asked questions

What is lacertus syndrome?

Lacertus syndrome is compression of the median nerve just below the elbow, under a band of tissue called the lacertus fibrosus. It mainly causes weakness of the thumb, index finger and wrist, with aching in the forearm.

How much does lacertus syndrome surgery cost in Cardiff?

Lacertus syndrome release at Excel Clinic costs £2,050. It is a fixed, all-inclusive price covering the anaesthetic, surgery, aftercare and follow-up. The first video consultation is free.

How is lacertus syndrome different from carpal tunnel syndrome?

Both affect the median nerve. Carpal tunnel syndrome is compression at the wrist and mainly causes numbness and tingling, often at night. Lacertus syndrome is compression just below the elbow and mainly causes weakness of the thumb, index finger and wrist, with forearm ache. Some people have both.

Why did my carpal tunnel surgery not help?

One possible reason is that the median nerve is also compressed higher up, at the lacertus. Mr Phillips can examine you for lacertus syndrome and other causes of persistent symptoms.

How is lacertus syndrome diagnosed?

Mainly by examination. A hand surgeon tests the strength of specific muscles and checks for tenderness over the nerve below the elbow. Nerve conduction studies are often normal, so a normal test does not rule it out.

What is WALANT?

WALANT stands for wide awake local anaesthetic, no tourniquet. The area is numbed with local anaesthetic mixed with a medicine that reduces bleeding, so no tourniquet, sedation or general anaesthetic is needed. You stay awake and comfortable, and can go home straight afterwards.

Is lacertus release painful?

The local anaesthetic stings briefly, then the area goes numb and you should feel no pain during the operation. Afterwards most people need only simple painkillers for a few days.

How long is recovery after lacertus release?

Most people use the hand for light tasks straight away and are back at desk work within a few days. Heavier lifting and gym work are built up over 2 to 4 weeks.

Can I have my consultation and treatment on the same day?

Yes, where it is clinically appropriate. With a one-stop appointment Mr Phillips assesses you and carries out the procedure in the same visit, and the consultation fee is included in the package. If you would rather have a separate consultation first, it costs £250.

Do I need a GP referral?

No. You can refer yourself. Complete the booking form and we will arrange your free video consultation.

Still have a question? Send us a message or call 02922 645305.

Book your lacertus syndrome consultation

Free video consultation, a fixed all-inclusive price and wide-awake surgery with a consultant hand surgeon.

Book your free video consultation

Tell us about your symptoms and any previous treatment, such as carpal tunnel surgery, and our team will be in touch to arrange your video consultation.

Find us

Excel Clinic
3 Oaktree Court, Mulberry Drive
Cardiff Gate Business Park
Cardiff CF23 8RS

Just off Junction 30 of the M4, with designated patient parking. Open Monday to Friday, 9am to 5pm.

02922 645305 · info@excelclinic.co.uk