Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York, U.S.A.
Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Bronx, New York, U.S.A..
Arthroscopy. 2017 Nov;33(11):1958-1962. doi: 10.1016/j.arthro.2017.06.050. Epub 2017 Sep 29.
To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development.
We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded. LFCN palsy symptoms were recorded prospectively at the initial postoperative visit and identified clinically by focal pain, numbness, and/or tingling over the anterolateral thigh.
The median patient age was 59.0 years and consisted of 158 males (40%) and 239 (60%) females. Five cases of LFCN palsy were identified for a prevalence of 1.3%. These patients had a higher median weight (108.9 kg vs 80.7 kg, P = .005) and BMI (39.6 vs 29.4, P = .005) than the patients who did not develop LFCN palsy. Median age, gender, diabetes, and surgical time were not significantly different between the groups. All cases resolved completely within 6 months.
LFCN palsy after shoulder surgery in the beach chair position in our study has a prevalence of 1.3%, making it an uncommon complication. Patients with elevated BMI should be counseled about its possible occurrence after shoulder surgery in the beach chair position.
Level IV, prognostic.
报告在沙滩椅位行肩部手术的患者中发生外侧股皮神经（LFCN）麻痹的发生率，并确定发生该并发症的患者和手术相关危险因素。
我们回顾性分析了由同一位外科医生采用沙滩椅位行开放或关节镜下肩部手术的 397 例连续患者的病历。记录了患者的人口统计学和手术数据，包括年龄、性别、体重、体重指数（BMI）、糖尿病、手术持续时间以及麻醉类型（全身麻醉、区域麻醉、区域麻醉/全身麻醉）。LFCN 麻痹症状在术后首次就诊时通过临床检查前瞻性记录，表现为大腿前外侧局灶性疼痛、麻木和/或刺痛。
患者的中位年龄为 59.0 岁，包括 158 名男性（40%）和 239 名女性（60%）。共发现 5 例 LFCN 麻痹，发生率为 1.3%。这些患者的体重中位数（108.9kg 比 80.7kg，P=0.005）和 BMI 中位数（39.6 比 29.4，P=0.005）高于未发生 LFCN 麻痹的患者。两组患者的中位年龄、性别、糖尿病和手术时间无显著差异。所有病例均在 6 个月内完全缓解。
本研究中沙滩椅位行肩部手术后 LFCN 麻痹的发生率为 1.3%，是一种罕见的并发症。对于 BMI 较高的患者，应在沙滩椅位行肩部手术后告知其发生该并发症的可能性。
IV 级，预后。
