Cure of Fingertip Necrosis after Median Nerve Block Application in Two Cases of Definite and Probable Systemic Sclerosis.

Abstract

One patient with systemic sclerosis with index fingertip necrosis and another with probable systemic sclerosis with index and middle fingertip impending necroses were successfully treated with ultrasound-guided median nerve block application on the affected side. The nailfold temperatures of the affected fingers measured using thermography were below 25°C. Immediately after application, the temperature increased substantially. After repeated applications, the mean basal temperature on the affected side increased by 3.6°C in Case 1 and by 5.9°C in Case 2. Peripheral nerve block can be a basic treatment for fingertip necrosis. The thermographical observation of the extent and region in which the temperature increased is novel.