Hussain S Ahmed, Holland Danielle
Gynecologic Surgery and Obstetrics, Royal Air Force (RAF) Lakenheath Hospital, Lakenheath, GBR.
Cureus. 2022 Aug 19;14(8):e28161. doi: 10.7759/cureus.28161. eCollection 2022 Aug.
To avoid the nerves and blood vessels of the upper extremity, the subdermal contraceptive implant Nexplanon (N.V. Organon, Oss, The Netherlands) is inserted into the subdermis at a location 8-10 cm proximal to the medial epicondyle of the humerus and 3-5 cm posterior to the groove between the biceps and triceps muscles. Ulnar nerve injury is a known but extremely rare complication associated with implant insertion. Risk factors for ulnar nerve insult include inadvertent deep insertion, device migration, and an underweight patient. This is a case report of an obese 40-year-old female who presented four days after uncomplicated contraceptive implant insertion with symptoms consistent with an acute ulnar neuropathy, despite the implant being located in the proper superficial location. Symptoms resolved soon after implant removal. This unique presentation may be explained by the aberrant anatomy of the ulnar nerve. It is important for clinicians to be able to recognize and treat this rare complication of contraceptive implant insertion, even in a patient who possesses no risk factors for ulnar nerve injury.
为避免损伤上肢的神经和血管，皮下避孕植入剂依伴侬（荷兰欧加农公司，奥斯）被植入到肱骨内上髁近端8 - 10厘米、肱二头肌与肱三头肌之间沟后方3 - 5厘米处的皮下。尺神经损伤是一种已知但极其罕见的与植入剂插入相关的并发症。尺神经受损伤的危险因素包括无意的深部插入、装置移位以及体重过轻的患者。本文报告一例40岁肥胖女性病例，在无并发症的避孕植入剂插入术后四天出现与急性尺神经病变相符的症状，尽管植入剂位于正确的浅表位置。植入剂取出后症状很快缓解。这种独特的表现可能由尺神经的异常解剖结构来解释。临床医生能够识别并治疗这种避孕植入剂插入的罕见并发症非常重要，即使在没有尺神经损伤危险因素的患者中也是如此。
