Zeng Zeng, Chen Cong-Xian
Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou 310000, Zhejiang Province, China.
World J Clin Cases. 2022 Feb 6;10(4):1320-1325. doi: 10.12998/wjcc.v10.i4.1320.
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.
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.
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.
桡神经（RN）在肘部分为两个主要分支：桡神经浅支（SBRN）和桡神经深支。由于其表浅的特点，SBRN在急性创伤中容易受损。
一名55岁男性患者10个月前右手腕受伤。在急诊室进行了清创、缝合和包扎。瘢痕愈合6个月后，他感到右手拇指背侧麻木和刺痛。因此进行了SBRN切除吻合手术。病理结果显示为创伤性神经瘤。手术后4个月，患者右手拇指背侧再次感到麻木和刺痛。手术区域压痛明显。超声显示SBRN与周围组织粘连。患者拒绝进一步手术治疗，接受了超声引导下SBRN针刀松解加皮质类固醇注射。4周后，手术区域压痛减轻70%，右手拇指背侧麻木减轻40%，超声评估的神经肿胀减轻。4个月后，他未感到右手腕有任何麻木或刺痛感。这是首例关于超声引导下SBRN针刀松解加皮质类固醇注射的报道。
超声可评估RN的状况及其与周围组织的关系。超声引导下针刀松解加皮质类固醇注射是治疗SBRN粘连的一种有效且安全的方法。
