Ultrasound-guided radial nerve release for lateral intermuscular septum syndrome.

Abstract

Radial nerve entrapment at the lateral intermuscular septum in the distal upper arm can cause debilitating pain and functional impairment. The nerve passes from the dorsal to the volar compartment through the LIS, approximately 8-10 cm proximal to the lateral epicondyle, making it susceptible to compression. Clinical signs include wrist drop, localized pain, and weakness in wrist and finger extension, often seen in manual laborers and athletes. A minimally invasive, ultrasound-guided, percutaneous technique using local anesthesia and no tourniquet allows precise nerve decompression while preserving function. Hydrodissection under Doppler ultrasound ensures safety and avoids complications such as nerve palsy. This approach minimizes tissue disruption compared to traditional open decompression. Despite promising results, the technique remains under-researched, with no large-scale clinical trials available. Prospective studies with long-term follow-up are essential to establish the efficacy of this innovative, patient-centered technique.