Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis

Arthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN) is a very rare complication of shoulder arthroscopy. An analysis of pe...

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Main Authors: Jeremiah T. Steed, Kathlyn Drexler, Adam N. Wooldridge, Matthew Ferguson
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2017/7252953
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author Jeremiah T. Steed
Kathlyn Drexler
Adam N. Wooldridge
Matthew Ferguson
author_facet Jeremiah T. Steed
Kathlyn Drexler
Adam N. Wooldridge
Matthew Ferguson
author_sort Jeremiah T. Steed
collection DOAJ
description Arthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN) is a very rare complication of shoulder arthroscopy. An analysis of peer-reviewed published literature revealed only three articles reporting a total of seven cases that describe this specific complication following standard shoulder arthroscopic procedures. This article reports on three patients diagnosed with AIN neuropraxia following routine shoulder arthroscopy done by a single surgeon within a three-year period. All three patients also underwent open biceps tenodesis immediately following completion of the arthroscopic procedures. The exact causal mechanism of AIN neuropraxia following shoulder arthroscopy with biceps tenodesis is not known. This case report reviews possible mechanisms with emphasis on specific factors that make a traction injury the most likely etiology in these cases. We critically analyze our operating room setup and patient positioning practices in light of the existing biomechanical and cadaveric research to propose changes to our standard practices that may help to reduce the incidence of this specific postoperative complication in patients undergoing elective shoulder arthroscopy with biceps tenodesis.
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spelling doaj-art-c8a510b8252b4bf9b3e29130e931151e2025-08-20T03:23:42ZengWileyCase Reports in Orthopedics2090-67492090-67572017-01-01201710.1155/2017/72529537252953Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps TenodesisJeremiah T. Steed0Kathlyn Drexler1Adam N. Wooldridge2Matthew Ferguson3Texas Tech University Health Sciences Center, Department of Orthopaedic Surgery and Rehabilitation, 3601 4th St. MS 9436, Lubbock, TX 79430, USATexas Tech University Health Sciences Center, Department of Orthopaedic Surgery and Rehabilitation, 3601 4th St. MS 9436, Lubbock, TX 79430, USATexas Tech University Health Sciences Center, Department of Orthopaedic Surgery and Rehabilitation, 3601 4th St. MS 9436, Lubbock, TX 79430, USATexas Tech University Health Sciences Center, Department of Orthopaedic Surgery and Rehabilitation, 3601 4th St. MS 9436, Lubbock, TX 79430, USAArthroscopic rotator cuff tendon repair is a common elective procedure performed by trained orthopaedic surgeons with a relatively low complication rate. Specifically, isolated neuropraxia of the anterior interosseous nerve (AIN) is a very rare complication of shoulder arthroscopy. An analysis of peer-reviewed published literature revealed only three articles reporting a total of seven cases that describe this specific complication following standard shoulder arthroscopic procedures. This article reports on three patients diagnosed with AIN neuropraxia following routine shoulder arthroscopy done by a single surgeon within a three-year period. All three patients also underwent open biceps tenodesis immediately following completion of the arthroscopic procedures. The exact causal mechanism of AIN neuropraxia following shoulder arthroscopy with biceps tenodesis is not known. This case report reviews possible mechanisms with emphasis on specific factors that make a traction injury the most likely etiology in these cases. We critically analyze our operating room setup and patient positioning practices in light of the existing biomechanical and cadaveric research to propose changes to our standard practices that may help to reduce the incidence of this specific postoperative complication in patients undergoing elective shoulder arthroscopy with biceps tenodesis.http://dx.doi.org/10.1155/2017/7252953
spellingShingle Jeremiah T. Steed
Kathlyn Drexler
Adam N. Wooldridge
Matthew Ferguson
Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
Case Reports in Orthopedics
title Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
title_full Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
title_fullStr Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
title_full_unstemmed Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
title_short Anterior Interosseous Nerve Neuropraxia Secondary to Shoulder Arthroscopy and Open Subpectoral Long Head Biceps Tenodesis
title_sort anterior interosseous nerve neuropraxia secondary to shoulder arthroscopy and open subpectoral long head biceps tenodesis
url http://dx.doi.org/10.1155/2017/7252953
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AT adamnwooldridge anteriorinterosseousnerveneuropraxiasecondarytoshoulderarthroscopyandopensubpectorallongheadbicepstenodesis
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