Major Peripheral Nerve Injuries After Elbow Arthroscopy

• Published in: Arthroscopy Vol. 32; no. 6; pp. 999 - 1002.e8
• Main Authors: Desai, Mihir J., M.D, Mithani, Suhail K., M.D, Lodha, Sameer J., M.D, Richard, Marc J., M.D, Leversedge, Fraser J., M.D, Ruch, David S., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016
• Subjects: Arthroscopy - adverse effects; Brachial Plexus - injuries; Elbow Joint - surgery; Humans; Orthopedics; Postoperative Complications; Recovery of Function; Surveys and Questionnaires
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2015.11.023

Purpose To survey the American Society for Surgery of the Hand membership to determine the nature and distribution of nerve injuries treated after elbow arthroscopy. Methods An online survey was sent to all members of the American Society for Surgery of the Hand under an institutional review board–approved protocol. Collected data included the number of nerve injuries observed over a 5-year period, the nature of treatment required for the injuries, and the outcomes observed after any intervention. Responses were anonymous, and results were securely compiled. Results We obtained 372 responses. A total of 222 nerve injuries were reported. The most injured nerves reported were ulnar, radial, and posterior interosseous (38%, 22%, and 19%, respectively). Nearly half of all patients with injuries required operative intervention, including nerve graft, tendon transfer, nerve repair, or nerve transfer. Of the patients who sustained major injuries, those requiring intervention, 77% had partial or no motor recovery. All minor injuries resolved completely. Conclusions Our results suggest that major nerve injuries after elbow arthroscopy are not rare occurrences and the risk of these injuries is likely under-reported in the literature. Furthermore, patients should be counseled on this risk because most nerve injuries show only partial or no functional recovery. With the more widespread practice of elbow arthroscopy, understanding the nature and sequelae of significant complications is critically important in ensuring patient safety and improving outcomes.