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Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player

Peripheral nerve injury in athletes is rare but deleterious to their performance, entrapment being one of the most frequent causes. Isolated injury to the superficial peroneal nerve (SPN) is rare and often underdiagnosed. The authors reported a clinical case of a 34-year-old handball athlete who pre...

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Autores principales: Martins da Silva, Rui, Pereira, Adriana, Branco, Raquel, Carvalho, José Luís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427882/
https://www.ncbi.nlm.nih.gov/pubmed/37593284
http://dx.doi.org/10.7759/cureus.42043
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author Martins da Silva, Rui
Pereira, Adriana
Branco, Raquel
Carvalho, José Luís
author_facet Martins da Silva, Rui
Pereira, Adriana
Branco, Raquel
Carvalho, José Luís
author_sort Martins da Silva, Rui
collection PubMed
description Peripheral nerve injury in athletes is rare but deleterious to their performance, entrapment being one of the most frequent causes. Isolated injury to the superficial peroneal nerve (SPN) is rare and often underdiagnosed. The authors reported a clinical case of a 34-year-old handball athlete who presented with neuropathic pain in the inferolateral third of the leg and dorsum of the foot, with three months of evolution, after an ankle sprain, refractory to conservative treatment. After clinical assessment and ultrasound investigation, it was considered that the pain source was likely to be an SPN entrapment. Thus, a diagnostic ultrasound-guided nerve block with 2ml of 2% lidocaine and 3ml of 0.2% ropivacaine was performed, followed by nerve hydrodissection, with a major improvement in the patient's symptoms and functionality for three weeks. Thereafter, a long-lasting alternative was made - pulsed radiofrequency (pRF). There were no complications after the procedure. As a form of neuromodulation, pRF offered pain resolution without tissue damage or painful sequela, after 3, 6, 12, and 24 months of follow-up and complete participation in sports activity, avoiding surgical treatment. With this clinical case, the authors intend to demonstrate the effectiveness of pRF in the resolution of peripheral neuropathy due to entrapment, avoiding more invasive treatment options and, in the case of an athlete, allowing an early return to play. They also intend to corroborate the advantage of using ultrasound in the diagnosis and guide of minimally invasive procedures.
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spelling pubmed-104278822023-08-17 Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player Martins da Silva, Rui Pereira, Adriana Branco, Raquel Carvalho, José Luís Cureus Pain Management Peripheral nerve injury in athletes is rare but deleterious to their performance, entrapment being one of the most frequent causes. Isolated injury to the superficial peroneal nerve (SPN) is rare and often underdiagnosed. The authors reported a clinical case of a 34-year-old handball athlete who presented with neuropathic pain in the inferolateral third of the leg and dorsum of the foot, with three months of evolution, after an ankle sprain, refractory to conservative treatment. After clinical assessment and ultrasound investigation, it was considered that the pain source was likely to be an SPN entrapment. Thus, a diagnostic ultrasound-guided nerve block with 2ml of 2% lidocaine and 3ml of 0.2% ropivacaine was performed, followed by nerve hydrodissection, with a major improvement in the patient's symptoms and functionality for three weeks. Thereafter, a long-lasting alternative was made - pulsed radiofrequency (pRF). There were no complications after the procedure. As a form of neuromodulation, pRF offered pain resolution without tissue damage or painful sequela, after 3, 6, 12, and 24 months of follow-up and complete participation in sports activity, avoiding surgical treatment. With this clinical case, the authors intend to demonstrate the effectiveness of pRF in the resolution of peripheral neuropathy due to entrapment, avoiding more invasive treatment options and, in the case of an athlete, allowing an early return to play. They also intend to corroborate the advantage of using ultrasound in the diagnosis and guide of minimally invasive procedures. Cureus 2023-07-17 /pmc/articles/PMC10427882/ /pubmed/37593284 http://dx.doi.org/10.7759/cureus.42043 Text en Copyright © 2023, Martins da Silva et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pain Management
Martins da Silva, Rui
Pereira, Adriana
Branco, Raquel
Carvalho, José Luís
Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title_full Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title_fullStr Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title_full_unstemmed Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title_short Ultrasound-Guided Pulsed Radiofrequency Treatment for Superficial Peroneal Nerve Entrapment in a Professional Handball Player
title_sort ultrasound-guided pulsed radiofrequency treatment for superficial peroneal nerve entrapment in a professional handball player
topic Pain Management
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427882/
https://www.ncbi.nlm.nih.gov/pubmed/37593284
http://dx.doi.org/10.7759/cureus.42043
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