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Wednesday, 24 February 2016

Acupuncture needles with direct electrical stimulation helped speed up nerve regeneration and function recovery after forearm ulnar nerve injury – a case report

A male patient with deep cutting wound and total rupture of right proximal forearm ulnar nerve was treated with direct electrical stimulation of acupuncture needles plus daily rehabilitation activities recovered most of function and returned to work around three months of after surgery. A case study reported in journal of Complementary Therapies in Medicine.

A 32-year old male patient, in Taiwan, China, suffered a deep cut from a broken washbasin and total rupture of right proximal forearm ulnar nerve and partial rupture of many associated tendons. The wound immediately underwent irrigation and muscle and ulnar nerve repair surgery. Two weeks after operation, electroacupuncture was applied, using 2 needles inserted in the cubital tunnel along the site of the injured ulnar nerve and 10 needles inserted according to the origins of muscles innervated by the ulnar nerve and affected by the injury, and other 4 needles were inserted along the suture scar line to avoid possible soft tissue contractures. The procedure was executed once a week for 6 months plus daily rehabilitation activities.

The outcome was monitored using the Rosén and Lundborg (R&L) protocol and DASH scores once a month. The results gathered on the first day of intervention were regarded as the baseline.

It was found that pain/discomfort domain was the first to reach stable amelioration after the first month. The motor and sensory and domains reached stable growth in third and fourth months, respectively. The patient returned to work in third month after operation.

Authors suggested that direct electrical stimulation at the proximal site of the injured nerve can augment nerve regeneration by means of acceleration of axon regeneration, earlier target muscle reinnervation, improvements in axonal conduction speeds, and up-regulation and electrophoretic movement of neurotrophic and neurogrowth factors such as BDNF and its trkB receptors.

Reference

Tang YJ et al., Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report. Complementary Therapies in Medicine 24 (2016) 103–107.    http://www.complementarytherapiesinmedicine.com/article/S0965-2299(15)30024-8/abstract

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