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Ultrasound Evaluation of Upper Limb Sublesional Muscle Morphology in Cervical Spinal Cord Injury.

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January 2025

International Collaboration on Repair Discoveries (ICORD), Vancouver, British Columbia, Canada.

Introduction/aims: Upper limb paralysis is arguably the most limiting consequence of cervical spinal cord injury (cSCI). There is limited knowledge regarding the early structural changes of muscles implicated in grasp/pinch function and upper extremity nerve transfer surgeries. We evaluated: (1) muscle size and echo intensity (EI) in subacute cSCI (2-6 months) and (2) the influence of lower motor neuron (LMN) damage on these ultrasound parameters.

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Hourglass Constriction of a Single Fascicle of the Anterior Interosseous Nerve: A Case Report.

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February 2025

From the Department of Plastic, Hand and Faciomaxillary Surgery, The Alfred, Melbourne, Australia.

Hourglass fascicular constrictions have been reported in fewer than 100 cases globally and only in the upper limb. The etiology remains unknown. Patients often present with self-limiting pain in the affected limb followed by flaccid paralysis.

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Radial nerve compression at the arcade of Frohse is a rare but significant condition that typically presents with pain primarily after exertion and at night on the dorsal side of the forearm, more distally than tennis elbow pain, and weakness of the wrist extensors and the long fingers and thumb extensors. Traditional treatment often involves open surgery, resulting in significant scarring. This study introduces a novel percutaneous radial nerve release technique under complete ultrasound guidance and highlights its efficacy and safety.

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Cases: Two patients with spontaneous loss of thumb interphalangeal joint extension were referred after history, electrodiagnostic, and/or magnetic resonance imaging (MRI) findings were felt to demonstrate a posterior interosseous nerve (PIN) palsy. Subsequent physical examination and additional directed studies suggested an alternative explanation: rupture of the extensor pollicis longus (EPL) tendon, subsequently confirmed at surgery. An extensor indicis proprius to EPL transfer restored thumb function.

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