Early post-operative nerve complications after primary open Latarjet: a single-surgeon series of 164 shoulders

Post-operative nerve complications remain a concern following the Latarjet procedure due to the proximity of the musculocutaneous, axillary, and suprascapular nerves during key surgical steps. Reported incidence rates of nerve injuries with this procedure vary considerably in the literature. The aim of this study was to evaluate the incidence of early post-operative nerve complications in consecutive patients undergoing a primary open Latarjet procedure treated with a standardized surgical technique.

A single-center, single-surgeon retrospective case series of patients undergoing primary open Latarjet procedure between January 2019 and June 2025 was conducted. A total of 176 consecutive patients were identified, with 93.3% follow-up. All procedures were performed using a standard deltopectoral approach with a subscapularis split limited to the muscular portion and a vertical capsulotomy. Routine follow-up was conducted at four weeks, three months, and six months post-operatively with the senior surgeon. Medical records were reviewed for documentation of post-operative complications, neurological symptoms, referrals to a neurologist, performance of electromyography, and emergency department evaluations within the first six months after surgery.

Among the 164 included patients, 137 (83.5%) were male. The right shoulder was operated in 92 cases (56.1%), and the mean age at surgery was 27.4 ± 8.2 years (range, 16.4-69.0). Post-operatively, one patient (0.6%) developed a transient sensory neurapraxia of the median nerve, presenting as hypesthesia and paresthesia on the volar aspect of the thumb, which resolved by six months. No musculocutaneous, axillary, or suprascapular nerve deficits were identified, and no patient required surgical exploration or neurolysis. Two patients (1.2%) developed an acute surgical site infection requiring washout, débridement, and screw retention. One patient (0.6%) experienced a superficial venous thrombosis of the cephalic and basilic veins, managed with oral anticoagulation. One patient (0.6%) sustained a recurrent anterior dislocation following a new-onset epileptic seizure, treated conservatively. No additional clinical complications were documented. The overall early clinical complication rate was 3.0% (n = 5), and the reoperation rate within six months was 1.2% (n = 2).

In this single-surgeon consecutive series of primary open Latarjet procedures, early post-operative nerve complications were infrequent, and the overall clinical complication rate was low. These findings reflect outcomes achieved within a standardized surgical setting and should be interpreted in the context of surgeon experience and volume.