1000 Section - Promoting motor recovery in severe radial neuropathy: a case of serial D5W hydrodissection after postoperative nerve entrapment

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

AC

Alan C. Chang, MD

Resident Physician
National Taiwan University Hospital Hsinchu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)

Corresponding Author/Autor a quien dirigir la corr(s)

Chueh-Hung Wu, MD, PhD (he/him/his)

Associate Professor
National Taiwan University College of Medicine
Taipei City, Taipei, Taiwan (Republic of China)

Case Diagnosis: Radial nerve palsy following humeral fracture

Case Description: A 39-year-old man developed complete right radial nerve palsy after humerus fracture fixation. Ultrasound revealed marked radial nerve swelling entrapped within postoperative scar tissue from the spiral groove to the elbow, and focal swelling of the deep branch of the radial nerve at the supinator level. Electrodiagnostic studies confirmed severe radial neuropathy. The patient received serial D5W nerve hydrodissection. Sensory symptoms improved substantially after three sessions, followed by progressive motor recovery. After 12 sessions, muscle strength in the wrist, finger, and thumb extensors improved from 0 to 5, 4+, and 4−, respectively.

Discussions: This case demonstrates that nerve hydrodissection may remain effective even when performed more than two months after the onset of paralysis. Motor deficits appear to require more treatment sessions than sensory symptoms. The temporal association between hydrodissection and earlier-than-expected motor recovery raises the hypothesis that D5W hydrodissection may accelerate nerve regeneration or functional regain.

Conclusions: Serial ultrasound-guided D5W hydrodissection may be a valuable treatment option for radial nerve entrapment with severe motor deficits, potentially facilitating sensory and motor recovery even in delayed presentations. Further prospective studies are warranted.