Re: Tang JB. Primary versus secondary nerve compression neuropathy. J Hand Surg Eur. 2024, 49: 639–41.

The letter discusses the distinction between primary and secondary lacertus fibrosus syndrome (LS) and the need for cautious surgical treatment based on scientific evidence. Professor Tang emphasizes the rarity of primary LS in younger patients and warns against unnecessary surgeries. Another surgeon, Dr. Vastamäki, shares his experience with LS, highlighting the importance of clear diagnostic criteria and the need for further research to differentiate between primary and secondary LS. Both surgeons advocate for strict diagnostic criteria and the importance of randomized controlled trials in nerve entrapment surgery. [Extracted from the article]