Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2022; 10(4): 1320-1325
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1320
Ultrasound-guided needle release plus corticosteroid injection of superficial radial nerve: A case report
Zeng Zeng, Cong-Xian Chen
Zeng Zeng, Cong-Xian Chen, Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Zeng Z and Chen CX were responsible for substantial contributions to conception and design; Chen CX was responsible for the acquisition of data; Zeng Z was responsible for drafting the article; Zeng Z and Chen CX were responsible for the final approval of the version to be published.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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Corresponding author: Cong-Xian Chen, MM, Doctor, Department of Ultrasound, Zhejiang Provincial People's Hospital, No. 158 Shangtang Road, Hangzhou 310000, Zhejiang Province, China. kema320@qq.com
Received: August 4, 2021
Peer-review started: August 4, 2021
First decision: November 6, 2021
Revised: November 7, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Processing time: 172 Days and 17.9 Hours
Abstract
BACKGROUND

The radial nerve (RN) splits into two main branches at the elbow: The superficial branch of RN (SBRN) and the deep branch of RN. The SBRN can be easily damaged in acute trauma due to its superficial feature.

CASE SUMMARY

A 55-year-old male patient injured his right wrist 10 mo ago. Debridement, suturing and bandaging were performed in the emergency room. Six months after the scar had healed, he felt numbness and tingling in the dorsal surface of the thumb of the right hand. So the surgery of resection and SBRN anastomosis were performed. The pathological findings showed it as traumatic neuroma. Four months after surgery, the patient felt numbness and tingling in the right dorsal surface of the thumb again. The tenderness was marked in the operated area. Ultrasound indicated that the SBRN was adhered to the surrounding tissue. The patient refused further surgical treatment and underwent ultrasound-guided needle release plus corticosteroid injection of the SBRN. Four weeks later, the tenderness in the surgical area was reduced by 70%, the numbness in the dorsal surface of the thumb of the right hand was reduced by 40% and the nerve swelling evaluated by ultrasound was reduced. Four months passed, he did not feel any numbness or tingling sensation of his right wrist. This is the first report of ultrasound-guided needle release plus corticosteroid injection of the SBRN.

CONCLUSION

Ultrasound can evaluate the condition of the RN, and the relationship with surrounding tissues. Ultrasound-guided needle release plus corticosteroid injection is an effective and safe treatment for SBRN adhesion.

Keywords: Ultrasound-guided; Needle release; Superficial radial nerve; Traumatic neuroma; Corticosteroid injection; Case report

Core Tip: A patient felt numbness and tingling in the right dorsal surface of the thumb four months after traumatic neuroma resection and the superficial branch anastomosis. Ultrasound revealed that the superficial branch was adhered to the surrounding tissue. Four weeks after ultrasound-guided needle release plus corticosteroid injection of the superficial branch, the tenderness and numbness both reduced thus indicating ultrasound-guided needle release plus corticosteroid injection is an effective and safe treatment for superficial branch adhesion.