Intramuscular localisation of an etonogestrel contraceptive implant (Nexplanon®) in the upper arm: a case report

Abstract Introduction Subdermal contraceptive implants, such as the etonogestrel implant, are highly effective long-acting reversible contraceptives. Intramuscular localization of the implant is a rare complication, particularly when located within deep muscular planes. Case description We report a 28-year-old woman who had an etonogestrel implant inserted in her left arm 2 months prior. She presented with difficulty palpating the implant and localized arm discomfort. Plain radiography confirmed intramuscular localization of the implant. Surgical removal was performed successfully without complications. Learning point Intramuscular localization, although rare, can occur early after insertion and poses challenges for detection and removal. Proper insertion technique, immediate post-insertion palpation, and imaging for non-palpable implants are essential to ensure safe management. Learning points