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Related Experiment Videos

Iatrogenic nerve injuries during shoulder surgery.

Bradley C Carofino1, David M Brogan, Michelle F Kircher

  • 1Division of Hand Surgery, Department of Orthopedic Surgery (B.C.C., D.M.B., M.F.K., B.T.E., R.J.S., A.T.B., and A.Y.S.), and Department of Neurological Surgery (R.J.S.), Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for A.Y. Shin: shin.alexander@mayo.edu.

The Journal of Bone and Joint Surgery. American Volume
|September 20, 2013
PubMed
Summary

Iatrogenic nerve injuries after shoulder surgery can cause significant morbidity and often require surgical intervention. Peripheral nerve injuries are more treatable than brachial plexus injuries, necessitating early evaluation.

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Area of Science:

  • Orthopedic Surgery
  • Neurology
  • Surgical Complications

Background:

  • Neurologic injuries from shoulder surgery are considered infrequent with minimal morbidity.
  • This study reviews institutional experience with iatrogenic nerve injuries post-shoulder surgery.

Purpose of the Study:

  • To analyze the characteristics and outcomes of patients with iatrogenic nerve injuries following shoulder surgery.
  • To identify factors influencing nerve injury severity and treatment efficacy.

Main Methods:

  • Retrospective review of 26 patients with iatrogenic nerve injury after shoulder surgery (2000-2010).
  • Data collected included operative procedure, presentation delay, examination findings, treatment, and outcomes.
  • Injuries were categorized by location (brachial plexus vs. terminal nerve branch) and type (structural vs. non-structural).

Main Results:

  • The average patient age was 43 years, with a mean referral delay of 5.4 months.
  • Injuries stemmed from various procedures: open instability (7), arthroscopic (9), total shoulder arthroplasty (4), and combined (6).
  • Fifteen patients (58%) required surgery due to lack of recovery; 35% had structural injuries (laceration/suture entrapment), more common in terminal nerve branch injuries.

Conclusions:

  • Shoulder surgery-related nerve injuries can lead to severe morbidity and necessitate surgical management.
  • Peripheral nerve injuries show better surgical treatability compared to brachial plexus injuries.
  • Early detection and referral are crucial for managing post-shoulder surgery iatrogenic neurologic deficits.