Sports Orthopedic Case of the Week – March 8, 2023
17 year old baseball player with 2 month gradual onset of left elbow pain. Sharp pain on the inside of the elbow with throwing motion. Numbness and tingling to the 4th and 5th fingers. Rest and anti-inflammatories provided no relief. Xrays were normal. On exam, he had tenderness over the UCL ligament, pain with stressing the UCL and tapping on the ulnar nerve reproduced tingling into the 4&5th fingers. I diagnosed him with a minor sprain the UCL along with ulnar neuropathy.
One month of physical therapy improved his UCL sprain but, the neuropathy symptoms persisted without change. Two weeks ago, I performed a hydrodissection procedure to the ulnar nerve. This is a simple, in-office procedure injecting a moderate volume of fluid (saline) around the nerve to expand the tissues surrounding the nerve. By stretching out the surrounding tissues, the nerve compression is resolved and the pain goes away. This is an effective treatment for many nerve compression issues including carpal tunnel syndrome.
Today, 2 weeks after hydrodissection, his nerve pain is 95% improved and he is ready to progress his physical therapy and begin return to throwing.
I’m happy to help with any sports injuries!
Dr. Steve Meyers, MD
817.335.4316
Ulnar nerve highlighted in yellow.
Needle (red lines) approaching the ulnar nerve.
Needle above the nerve injecting fluid to expand the tissues compressing the nerve.
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