Brachial Plexus Injuries During Shoulder Arthroplasty: What Causes Them and How to Prevent Them

Neurological complications have been reported to occur in 3% of hemiarthroplasties, 0.1% to 4% of anatomic total shoulder arthroplasties, and 2% to 4% of reverse total shoulder arthroplasties. The brachial plexus is most commonly involved. Observations in cadaver studies have suggested that the most likely etiology of these neuropathies is stretch of the brachial plexus secondary to patient arm positioning. Although the majority of these injuries resolve spontaneously, permanent and debilitating injuries do occur, but rarely. Cadaver and intraoperative nerve monitoring studies have identified shoulder abduction of >90 degrees; combinations of abduction, external rotation, and either flexion or extension; and combinations of adduction, extension, and either internal or external rotation as positions which cause nerve dysfunction.
Source: Techniques in Shoulder and Elbow Surgery - Category: Orthopaedics Tags: Techniques Source Type: research