Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Osteoarthritis (OA) of the trapeziometacarpal (TMC) joint is a common disabling condition with potential surgical resolution. However, complications following these procedures can include superficial radial neuropathy, contributing to hand disability. The aim of our study was to analyze pain management by neuromodulation of the superficial radial nerve (SRN).

Methods Patients undergoing TMC OA surgical procedures at Hospital Center between March 2012 and March 2022 were included. SRN diagnosis block was performed at the first visit with local anesthetic. One month after a successful diagnostic nerve block, pulsed radiofrequency (PRF) of the SRN was performed. Primary endpoint was pain at rest and the secondary outcomes were: hand grip, Functional Index Questionnaire (FIHOA) and Kapandji score.

Results 30 patients met the inclusion criteria. Of the total, 13 patients reported pain and paresthesia on the dorsolateral aspect of the hand, but only 6 patients agreed to participate. Of the total patients, 5 were female, with 2 patients reporting symptoms bilaterally. Pain at rest was described with a median of 8 [IQR 7-8] at baseline and 0 [IQR 0-1,24] after PFR (P = 0.011). Median hand grip (kg) after PFR was 26.8 [IQR 24-31.6] compared to 23.3 [IQR 22.5-25.7] from baseline (P = 0.025) and Kapandji score improved from 6 [IQR 5.8-7.3] from baseline to 7 [IQR 6-8] (P = 0.102). FIHOA index improved 16.5 [IQR 10-21] at baseline to 13.5 [IQR 7.8-18] (P = 0.02).

Conclusions Neuromodulation of SRN may represent a safe and effective approach to treat pain associated with TMC OA surgery.