遠位上腕二頭筋修復後の外側前腕皮神経障害：後向きレビュー

Lateral antebrachial cutaneous nerve neuropathy (LABCN) is a known complication following distal biceps tendon repair; however, potential risk factors leading to this are not well described. This retrospective study of distal biceps repairs seeks to determine associations between patient demographics, surgical technique, and injury characteristics associated with postoperative LABCN.

A retrospective chart review was performed on 275 patients with partial- or full-thickness biceps tendon ruptures who underwent operative repair. Patient characteristics were recorded including utilization of tobacco, alcohol, age, and body mass index, along with surgical factors including tourniquet time, approach, prior shoulder surgery, and tendon repair techniques. Lateral antebrachial cutaneous nerve neuropathy was identified by description of "numbness, tingling, burning, or decreased sensation" at postoperative visits. Chi-square and t tests were used to analyze differences in LABCN development rate for the listed variables.

Sixty-three of 275 (22.9%) patients were identified as having some form of LABCN postoperatively. Age, body mass index, and tourniquet time were not correlated with LABCN (P > .05). The 2-incision technique and the use of corkscrew anchor fixation correlated with lower LABCN rates (P < .05). Chronic biceps rupture, partial thickness tear, and history of prior ipsilateral shoulder surgery correlated with higher LABCN rates (P > .05).

Multiple factors affect the risk of LABCN after distal biceps repair. Patient-related factors do not appear to be associated with increased risk, except in cases where patients have a history of shoulder surgery or chronic distal biceps rupture. Surgical factors such as approach and method of tendon fixation demonstrate differences in the rate of postoperative LABCN.