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Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report

The radial nerve is the most frequently injured nerve in the upper extremity. Numerous options in treatment have been described for radial nerve injury, such as neurolysis, nerve grafts, or tendon transfers. Currently, new treatment options are arising, such as platelet-rich plasma (PRP), an autolog...

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Autores principales: García de Cortázar, Unai, Padilla, Sabino, Lobato, Enrique, Delgado, Diego, Sánchez, Mikel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852429/
https://www.ncbi.nlm.nih.gov/pubmed/29382110
http://dx.doi.org/10.3390/jcm7020013
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author García de Cortázar, Unai
Padilla, Sabino
Lobato, Enrique
Delgado, Diego
Sánchez, Mikel
author_facet García de Cortázar, Unai
Padilla, Sabino
Lobato, Enrique
Delgado, Diego
Sánchez, Mikel
author_sort García de Cortázar, Unai
collection PubMed
description The radial nerve is the most frequently injured nerve in the upper extremity. Numerous options in treatment have been described for radial nerve injury, such as neurolysis, nerve grafts, or tendon transfers. Currently, new treatment options are arising, such as platelet-rich plasma (PRP), an autologous product with proved therapeutic effect for various musculoskeletal disorders. We hypothesized that this treatment is a promising alternative for this type of nerve pathology. The patient was a healthy 27-year-old man who suffered a deep and long cut in the distal anterolateral region of the right arm. Forty-eight hours after injury, an end-to-end suture was performed without a microscope. Three months after the surgery, an electromyogram (EMG) showed right radial nerve neurotmesis with no tendency to reinnervation. Four months after the trauma, serial intraneural infiltrations of PRP were conducted using ultrasound guidance. The therapeutic effect was assessed by manual muscle testing and by EMG. Fourteen months after the injury and 11 months after the first PRP injection, functional recovery was achieved. The EMG showed a complete reinnervation of the musculature of the radial nerve dependent. The patient remains satisfied with the result and he is able to practice his profession. Conclusions: PRP infiltrations have the potential to enhance the healing process of radial nerve palsy. This case report demonstrates the therapeutic potential of this technology for traumatic peripheral nerve palsy, as well as the apt utility of US-guided PRP injections.
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spelling pubmed-58524292018-03-19 Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report García de Cortázar, Unai Padilla, Sabino Lobato, Enrique Delgado, Diego Sánchez, Mikel J Clin Med Case Report The radial nerve is the most frequently injured nerve in the upper extremity. Numerous options in treatment have been described for radial nerve injury, such as neurolysis, nerve grafts, or tendon transfers. Currently, new treatment options are arising, such as platelet-rich plasma (PRP), an autologous product with proved therapeutic effect for various musculoskeletal disorders. We hypothesized that this treatment is a promising alternative for this type of nerve pathology. The patient was a healthy 27-year-old man who suffered a deep and long cut in the distal anterolateral region of the right arm. Forty-eight hours after injury, an end-to-end suture was performed without a microscope. Three months after the surgery, an electromyogram (EMG) showed right radial nerve neurotmesis with no tendency to reinnervation. Four months after the trauma, serial intraneural infiltrations of PRP were conducted using ultrasound guidance. The therapeutic effect was assessed by manual muscle testing and by EMG. Fourteen months after the injury and 11 months after the first PRP injection, functional recovery was achieved. The EMG showed a complete reinnervation of the musculature of the radial nerve dependent. The patient remains satisfied with the result and he is able to practice his profession. Conclusions: PRP infiltrations have the potential to enhance the healing process of radial nerve palsy. This case report demonstrates the therapeutic potential of this technology for traumatic peripheral nerve palsy, as well as the apt utility of US-guided PRP injections. MDPI 2018-01-29 /pmc/articles/PMC5852429/ /pubmed/29382110 http://dx.doi.org/10.3390/jcm7020013 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
García de Cortázar, Unai
Padilla, Sabino
Lobato, Enrique
Delgado, Diego
Sánchez, Mikel
Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title_full Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title_fullStr Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title_full_unstemmed Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title_short Intraneural Platelet-Rich Plasma Injections for the Treatment of Radial Nerve Section: A Case Report
title_sort intraneural platelet-rich plasma injections for the treatment of radial nerve section: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852429/
https://www.ncbi.nlm.nih.gov/pubmed/29382110
http://dx.doi.org/10.3390/jcm7020013
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