# Hydrodissection of the Eighth Cervical Nerve Root for Scapular Girdle Pain Associated With Nonunion of the First Rib Stress Fracture: A Case Report

## TL;DR

A gymnast with a non-healing first rib fracture found pain relief through a new treatment targeting the C8 nerve root.

## Contribution

A novel use of hydrodissection targeting the C8 nerve root for scapular girdle pain from a nonunion first rib stress fracture.

## Key findings

- The patient experienced pain relief after hydrodissection of the C8 nerve root.
- The gymnast returned to competition without pain recurrence for one year.
- The case suggests a possible link between first rib nonunion and C8 nerve root involvement.

## Abstract

The first rib stress fracture is a rare overuse injury, with nonunion posing challenges to athletic performance. We report an 18-year-old international-level gymnast diagnosed with the nonunion of the first rib stress fracture, experiencing pain extending to the medial scapular area. Traditional treatments provided no relief, with tests suggesting C8 nerve root involvement. This study introduces a novel approach targeting the C8 nerve root using hydrodissection, which alleviates the pain. Post-procedure, the patient resumed competition without recurrence of pain after a year. This case suggests that pain due to first rib stress fracture nonunion might be associated with the C8 nerve root, and hydrodissection could be a potentially effective treatment.