Background: Subcutaneous contraceptive implants are recommended to be placed in the medial upper arm. Here, the implant lies close to important neurovascular structures.
Case Presentation: We have treated two women with ulnar nerve injuries after removal of such implants. Patient 1 sustained a near complete nerve injury. Despite nerve grafting and a distal nerve transfer, she had a poor outcome. Patient 2 had a partial injury and has made a reasonable recovery after neurolysis of the ulnar nerve that was entrapped in scar tissue.
Interpretation: Prognosis after peripheral nerve injuries in the upper arm in adults is poor, and as such these injuries are particularly serious. Any patient with an implant that is not readily palpable in the subcutaneous tissue should be referred to a hand surgeon who has training in exploring peripheral nerves. If emergent nerve injury is suspected, referral to a department of hand surgery is vital.
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http://dx.doi.org/10.4045/tidsskr.20.0806 | DOI Listing |
Neurospine
December 2024
Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Objective: Uniportal full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) carries a unique risk of nerve traction and abrasion injury during cage insertion. This study aims to evaluate the clinical efficacy of the GUARD technique and delayed ligamentum flavectomy in reducing postoperative radicular pain and neurapraxia in patients undergoing uniportal FE-TLIF.
Methods: A retrospective analysis was conducted on 45 patients with an average age of 53.
Neurospine
December 2024
Department of Orthopedic Surgery, Spine Center, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Objective: To compare the safety profiles of biportal endoscopic spinal surgery (BESS) and microscopic spinal surgery (MSS) for lumbar disc herniation and spinal stenosis by analyzing the associated adverse events.
Methods: We pooled data from 2 prospective randomized controlled trials involving 220 patients (110 in each group) who underwent single-level lumbar surgery. Participants aged 20-80 years with radiating pain due to lumbar disc herniation or spinal stenosis were included in this study.
Neurospine
December 2024
Department of Orthopedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
This video presents a case of L4-5 unstable spondylolisthesis treated with full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF), emphasizing the GUARD (Glider Used as a Rotary Device) technique for nerve root protection. This innovative approach involves controlled rotation of the cage glider before cage insertion to minimize the risk of nerve root injury, a significant complication in Endo-TLIF procedures. The GUARD technique, validated in previous cadaveric studies, provides enhanced safety during cage insertion by protecting the nerve root.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Orthopaedics, School of Medicine, University of Phayao, Phayao, Thailand. Electronic address:
Introduction And Importance: Fractures of ossified Achilles tendons are rare and often associated with repetitive jumping and sprinting in young athletes. Although the exact cause of Achilles tendon ossification is unclear, prior trauma and surgery are common contributing factors.
Case Presentation: A 47-year-old male recreational athlete experienced acute pain in his right heel after a football game.
Int Immunopharmacol
January 2025
Xiangshan Hospital of Wenzhou Medical University, Ningbo, Zhejiang 315700, P.R. China. Electronic address:
Background: Peripheral nerve injury (PNI) is a common clinical problem that can result in partial or complete loss of sensory, motor, and autonomic functions. Tetrahydropalmatine (THP), a Corydalis yanhusuo-derived phytochemical alkaloid, possesses hypnotic, soothing, analgesic, and other effects, but little is known about the effect of THP on moderating peripheral nerve regeneration and its possible underlying mechanism of action.
Purpose: In this study, we aim to elucidate the protective function of THP on PNI and further reveal the underlying pharmacological mechanisms.
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