Begin the ultrasound instrument set up by entering the patient ID number and the patient's name to save the images. Sanitize the ultrasound probe using equipment disinfectant wipes. Perform all the procedures with the probe covered with surgical gloves.
To set the image of the DBRN in the middle of the screen, perform cross-sectional scanning along the patient's supinator muscle to find the DBRN. Then rotate the probe at 90 degrees to obtain a long axis section. Under continuous ultrasound guidance, separate the adhesion between the surrounding tissue of the posterior spin muscles and the DBRN.
Ask the patient to sit and place the patient's arm in a flexed 20 degrees position on the examination bed. Perform ultrasound to check for DBRN adhesion to the surrounding tissue. To begin the ultrasound examination, disinfect the patient's skin three times using complex iodine.
Then place a sterile surgical towel on the patient's arm. After providing the local anesthesia, identify the radial nerve by transversely using the probe at the level of the lateral epicondyle of the humerus. The radial nerve is located between the humerus muscle and the brachioradial muscle.
Then move the probe distally to find the deep branch of the radial nerve between the deep and superficial layers of the supinator. Use a five milliliter syringe to separate the adhesion between the surrounding tissue of the posterior spin muscles and the DBRN under continuous ultrasound guidance. Perform needle release from the DBRN distal area to the proximal area.
Prick the adhesion tissue back and forth with the tip. Control the probe and the needle accurately and ensure the tip is visible during the entire operation. Stop if there is resistance between the syringe and the tissues around the DBRN to avoid damaging the DBRN.
After the procedure, inject a mixture of one milliliter of corticosteroid betamethasone and two milliliters of 2%lidocaine into the superficial area of the DBRN. One month after the treatment, the finger joints were fully straightened. Upon fully straightening the fingers, the dorsal extension of the ring and little fingers was significantly improved by minus 15 degrees and minus 25 degrees respectively.
Three months after the treatment, the range of DBRN adhesions was significantly reduced compared to DBRN adhesions before the treatment. The dorsal extension of the ring and little fingers was also improved by minus 10 degrees and minus 15 degrees respectively. After one month when the same treatment was performed for the second time, the joints of the fingers were fully straightened with the ring finger and little finger at zero degrees, indicating the dorsal extensions of the ring and the little fingers were normal.
