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肘部手术中神经并发症的发生率及相关危险因素:2759例病例分析

The incidence of neurologic complications and associated risk factors in elbow surgery: an analysis of 2759 cases.

作者信息

van Rheenen Thijs A, van den Bekerom Michel P J, Eygendaal Denise

机构信息

Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands.

Shoulder and Elbow Unit, Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.

出版信息

J Shoulder Elbow Surg. 2015 Dec;24(12):1991-7. doi: 10.1016/j.jse.2015.07.033. Epub 2015 Oct 9.

Abstract

BACKGROUND

The purpose of this study was to evaluate the incidence of neurologic complications after elbow surgery and to provide perioperative tips and potential pitfalls for neurologic complications and how to cope with them.

METHODS

A single orthopedic surgeon performed 2759 elbow-related surgical procedures between January 2006 and October 2014. The surgical records and the postoperative follow-up of all 2759 patients were retrospectively reviewed to determine the preoperative diagnosis, the type of procedure, and postoperative neurologic complications.

RESULTS

Neurologic complications were very uncommon. Neurologic deficit occurred in 10 of 2759 elbow operations. A neurologic complication occurred 4 distal biceps tendon surgeries (5.3%), 4 elbow arthroscopies (0.4%), 2 ligament reconstructions (0.7%), and 2 total elbow prosthesis (1.4%).

CONCLUSIONS

A thorough understanding of the 3-dimensional anatomy of the elbow and surrounding nerves is needed to avoid neurologic complications. The neurologic complications we encountered in our series are well within the limits of earlier reports and show that elbow surgery is a relatively safe procedure to perform for a wide variety of indications.

摘要

背景

本研究的目的是评估肘部手术后神经并发症的发生率,并提供围手术期关于神经并发症的提示、潜在陷阱以及应对方法。

方法

2006年1月至2014年10月期间,一名骨科医生进行了2759例与肘部相关的外科手术。对所有2759例患者的手术记录和术后随访进行回顾性分析,以确定术前诊断、手术类型和术后神经并发症。

结果

神经并发症非常少见。2759例肘部手术中有10例出现神经功能缺损。4例肱二头肌远端肌腱手术(5.3%)、4例肘关节镜手术(0.4%)、2例韧带重建手术(0.7%)和2例全肘关节置换手术(1.4%)发生了神经并发症。

结论

需要全面了解肘部及周围神经的三维解剖结构以避免神经并发症。我们系列研究中遇到的神经并发症完全在早期报告的范围内,表明肘部手术对于各种适应症来说是一种相对安全的手术。

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