Radial Nerve Damage as a Complication of Elbow Arthroscopy

Arthroscopic elbow surgery, is it safe?

“…7,21,22,23,25,38,41 Elbow arthroscopy is a technically demanding surgery with many potential complications, such as a compartment syndrome, 2 septic arthritis, 18,27 superficial wound infection, 18,31 persistent drainage from portal sites, 18 and more specifically, transient or permanent injuries to the radial, ulnar, and median nerves, and nerve branches. 11,12,15,16,18,21,30,36,39 Most reports of these complications, however, are case studies or descriptive reports of relatively small series. Just one extensive series documenting complications due to elbow arthroscopy has been reported from a specialized center for elbow pathology in the USA, 18 where the procedures were performed by several different surgeons.…”

The course of the median and radial nerve across the elbow: an anatomic study

“…Along the joint line of the radial head, the distance of the radial head to the radial nerve averaged 8 mm and was as low as 2.0 mm in one case. Neurological deficits after arthroscopic arthrolysis have been described in literature [4][5][6][7]. Lynch et al [18] have shown that the risk of neurovascular complications can be reduced by insufflation of the joint with approximately 30-40 cc of fluid.…”

“…While it is generally considered as a relatively safe procedure, major complications can occur. Permanent nerve damage represents one catastrophic complication of arthroscopic arthrolysis and has been described in several case reports [4][5][6][7].…”

Arthroscopic management of elbow trauma

“…The position and mobility of the ulnar nerve should be determined. The risk to neurovascular structures has been reported; however, injury to these structures can be diminished by careful technique [3][4][5][6]. Portals should be created with a fully distended joint and the elbow flexed to 90(, especially while creating anterior portals, to provide maximal clearance from neurovascular structures [4].…”