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Related Experiment Videos

Ulnar nerve palsy after elbow arthroscopy.

Mark L Dumonski1, Robert A Arciero, Augustus D Mazzocca

  • 1Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|May 3, 2006
PubMed
Summary

Ulnar nerve injury is a rare complication of elbow arthroscopy. This case highlights how portal placement during arthroscopic surgery for osteochondritis dissecans can increase ulnar nerve injury risk.

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Area of Science:

  • Orthopedic Surgery
  • Neuroscience
  • Sports Medicine

Background:

  • Elbow arthroscopy is a minimally invasive procedure for treating various elbow conditions.
  • Osteochondritis dissecans of the capitulum can cause significant elbow pain and dysfunction.
  • Ulnar nerve injury is a known but uncommon complication of elbow procedures.

Observation:

  • A patient undergoing arthroscopic debridement and retrograde drilling for capitellar osteochondritis dissecans developed ulnar nerve injury.
  • The injury occurred following the creation of a proximal medial portal.
  • Standard portal placement aims to protect the ulnar nerve via the medial intermuscular septum.

Findings:

  • Proximal medial portal placement, especially when extended more proximally than standard, may increase the risk of iatrogenic ulnar nerve injury.

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  • The medial intermuscular septum typically shields the ulnar nerve during elbow arthroscopy.
  • This case suggests that deviations from standard portal placement can compromise this protective barrier.

    • Implications:

    • Surgeons should be vigilant about portal placement during elbow arthroscopy to minimize ulnar nerve injury risk.
    • Understanding the anatomical relationship between portal placement and the ulnar nerve is crucial for safe surgical technique.
    • Further research may be warranted to define optimal portal placement guidelines for specific elbow arthroscopic procedures.