Neuropathy associated with etonogestrel implant insertion.

The etonogestrel contraceptive implant (Implanon®) is an effective, long-acting subdermal method of hormonal contraception for women. We describe a case of forearm pain and hypoesthesia associated with the insertion of the Implanon® contraceptive implant in a healthy 26-year-old female. These symptoms were due to direct implant contact with the medial cutaneous nerve of the forearm. The importance of correct insertion technique is discussed. Care should be taken to avoid nerve injury during insertion of subdermal contraceptive implants. An understanding of regional anatomy and the correct insertion technique will prevent insertion-related complications. Nexplanon® has been developed to replace Implanon®. It has a redesigned applicator intended to increase insertion accuracy.