Radial nerve palsy after humeral revision in total elbow arthroplasty

Throckmorton, Thomas W.; Zarkadas, Peter C.; Sánchez-Sotelo, Joaquín; Morrey, B.F.

doi:10.1016/j.jse.2010.08.012

Cited by 20 publications

(3 citation statements)

References 22 publications

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“…Peripheral neurologic injury is an important complication following ankle arthroplasty, but its incidence is thought to be uncommon [1][2][3][4][5][6][7]. For lower limb arthroplasty, the common mechanisms related to neurologic injuries include traction, compression, entrapment, direct laceration, and indirect trauma [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Neurologic injuries after primary total ankle arthroplasty: prevalence and effect on outcomes

Primadi

Yoon

et al. 2015

Journal of Foot and Ankle Research

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BackgroundNeurologic injuries are complications that can arise after total joint arthroplasty. However, no comprehensive study has been conducted on peripheral nerve injuries after total ankle arthroplasty. The purpose of the present study was to identify the prevalence of neurologic injury following primary total ankle arthroplasty, the predisposing factors, and evaluate the effect on clinical outcomes.MethodsWe retrospectively analyzed 150 consecutive primary total ankle arthroplasty using the mobile-bearing prosthesis between January 2005 and December 2011, in 150 patients with symptomatic ankle end-stage arthritis. All the patients were divided into groups according to whether they had postoperative peripheral neuropathy (23 patients) or not (127 patients). We investigated the prevalence, predisposing factors, and effect on clinical outcomes of neurologic injuries. The mean age was 61.3 years, and the mean follow-up period was 41.8 months.ResultsThere were 23 nerve injuries (15.3 %), including nine in posterior tibial nerves, six superficial peroneal nerves, six deep peroneal nerves, one saphenous nerve, and one sural nerve. Neurologic injury was significantly associated with the development of posttraumatic osteoarthritis, but it was not significantly associated with other predisposing factors, such as age, gender, body mass index, and symptom duration. Of the 23 nerve injuries, 13 (56.5 %) presented a complete, spontaneous recovery, 9 (39.1 %) presented an incomplete recovery, and 1 (4.3 %) presented no recovery. The patients with neurologic injury had significantly lower American Orthopaedic Foot and Ankle Society scores and lower levels of patient satisfaction.ConclusionsThe results of this study suggest that the prevalence of neurologic injury after total ankle arthroplasty is considerable, and that neurologic injury is associated with low levels of patient satisfaction and poor clinical outcomes at mean of 3 years, postoperatively. Care is needed to reduce the occurrence of neurologic injuries.

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Section: Introductionmentioning

confidence: 99%

Neurologic injuries after primary total ankle arthroplasty: prevalence and effect on outcomes

Primadi

Yoon

et al. 2015

Journal of Foot and Ankle Research

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“…Wrist drop as a result of injury to the radial nerve represents a serious complication when approaching the distal humerus posteriorly-as in distal humeral fractures and in total elbow arthroplasty-which might reflect poorly on the clinical outcome of the patient [1][2][3][4][5][6][7][8][9]. Therefore, iatrogenic radial nerve lesions as a direct result of surgical exposure and dissection have to be avoided (Fig.…”

Section: Introductionmentioning

confidence: 99%

Radial nerve location at the posterior aspect of the humerus: an anatomic study of 100 specimens

Hackl

Damerow

Leschinger

et al. 2015

Arch Orthop Trauma Surg

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“…Avoiding the need for cerclage fixation and risk of injury to the radial nerve is also attractive. 21 In this study data were collected prospectively, and the classification system was subsequently applied. Further work is required to assess the effectiveness of this system, validate observer reliability, and confirm correct thresholds for critical defect size.…”

Section: Discussionmentioning

confidence: 99%

Revision of total elbow replacement by exchange cementing

Malone

SÁNCHEZ

Adams

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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We report the effectiveness of revision of total elbow replacement by re-cementing. Between 1982 and 2004, 53 elbows in 52 patients were treated with re-cementing of a total elbow replacement into part or all of the existing cement mantle or into the debrided host-bone interface, without the use of structural bone augmentation or a custom prosthesis. The original implant revision was still in situ and functional in 42 of 53 elbows (79%) at a mean of 94.5 months (26 to 266) after surgery. In 31 of these 42 elbows (74%) the Mayo Elbow Performance Score was good or excellent. Overall, of the 53 elbows, 18 (34%) required re-operation, ten (19%) for loosening. A classification system was developed to identify those not suitable for revision by this technique, and using this we have showed that successful re-implantation is statistically correlated to properly addressing the bone deficiency for both the humeral (p = 0.005) and the ulnar (p = 0.039) components.

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Radial nerve palsy after humeral revision in total elbow arthroplasty

Cited by 20 publications

References 22 publications

Neurologic injuries after primary total ankle arthroplasty: prevalence and effect on outcomes

Neurologic injuries after primary total ankle arthroplasty: prevalence and effect on outcomes

Radial nerve location at the posterior aspect of the humerus: an anatomic study of 100 specimens

Revision of total elbow replacement by exchange cementing

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