Successful Treatment of Posterior Interosseous Nerve Entrapment through Ultrasound-Guided Hydrodissection: A Case Report

Tsung-Hua C, Kai-Lang C and Pi-Ling T

Published on: 2024-07-31

Abstract

Purpose: Posterior Interosseous Nerve (PIN) entrapment, a rare peripheral nerve compression disorder, primarily affects motor function with weakness in thumb extension and interphalangeal joints. We present a case for a successful treatment through ultrasound-guided hydrodissection with corticosteroids.

Case Report: A 60-year-old patient with sudden left-hand weakness following prolonged compression during sleep. Clinical examination revealed impaired left wrist extension without sensory deficits. Neurological assessments, Nerve Conduction Studies (NCS) and soft tissue sonography confirmed PIN entrapment.

Ultrasound-guided hydrodissection, a minimally invasive approach using triamcinolone, successfully separated the entrapped nerve from adhesive tissues. The patient reported significant improvement in hand movement and muscle strength about one month later post-treatment. Subsequent hydrodissection further enhanced recovery, with complete restoration of muscle power at the four-month follow-up.

The use of corticosteroids in hydrodissection proved effective in reducing inflammation and promoting nerve repair. The procedure demonstrated safety, tolerability, and cost-effectiveness.

Conclusion: This case disclosed the efficacy of ultrasound-guided hydrodissection as a viable and minimally invasive therapeutic option for PIN entrapement, offering a promising alternative to traditional approaches. Further research is warranted to explore its applicability in broader clinical settings.