J Korean Orthop Assoc.  2009 Dec;44(6):675-679. 10.4055/jkoa.2009.44.6.675.

Brachial Plexus Injury as a Complication of Arthroscopic Bankart Repair: A Case Report

• Kim CK
• Jin CW
• Jung SW
• Lee JH

• KMID: 2186295
• DOI: http://doi.org/10.4055/jkoa.2009.44.6.675

Abstract

Shoulder arthroscopy is widely used through the development of arthroscopic technique and equipment but some complications have been reported that are related to the complexity of technique and the long duration time of operation. Brachial plexus injury, as a complication of arthroscopic Bankart repair, is rare, but remains a serious sequelae. We performed the neurorrhaphy and neurolysis of brachial plexus and showed relatively good functional outcome after 2 years.

Keyword

Brachial plexus injury; Arthroscopic bankart repair

MeSH Terms

Arthroscopy
Brachial Plexus
Shoulder

Figure

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  Fig. 1 Photography of brachial plexus injured right hand of 50-year-old man at first visit. Note muscular atrophy of hand and claw hand deformity.

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  Fig. 2 Radiography showed well aligned glenohumeral joint and 4 metal anchors which were used for Bankart repair.

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  Fig. 3 Photography after neurolysis of adhesion between brachial plexus and soft tissue, taken at operating field. Blue loop identified medial cord and red loop identified posterior cord.

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  Fig. 4 Microscopic photography after neurolysis. Central nerve was medial cord.

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  Fig. 5 At postoperative 24 months photography showed relatively good motion of right hand, and mild regeneration of thenar and hypothenar muscles.

Reference

1. Bigliani LU, Flatow EL, Deliz ED. Complications of shoulder arthroscopy. Orthop Rev. 1991. 20:743–751.

2. Roure P, Fontes D. Complication and prevention of upper limb joints arthroscopy. Chir Main. 2006. 25:Suppl. 274–279.

3. Struzik S, Glinkowski W, Gorecki A. Shoulder arthroscopy complications. Ortop Traumatol Rehabil. 2003. 30:489–494.

4. Boardman ND 3rd, Cofield RH. Neurologic complications of shoulder surgery. Clin Orthop Relat Res. 1999. 368:44–53.

5. Polzhofer GK, Petersen W, Hassenpflug J. Thromboembolic complication after arthroscopic shoulder surgery. Arthroscopy. 2003. 19:129–132.

6. Weber SC, Abrams JS, Nottage WM. Complications associated with arthroscopic shoulder surgery. Arthroscopy. 2002. 18:88–95.

7. McFarland EG, O'Neill OR, Hsu CY. Complications of shoulder arthroscopy. J South Orthop Assoc. 1997. 6:190–196.

8. Lo IK, Lind CC, Burkhart SS. Glenohumeral arthroscopy portals established using an outside-in technique: neurovascular anatomy at risk. Arthroscopy. 2004. 20:596–602.

9. Kim SS, Chun CH, Kim DC, Chae SU. Electrical Stimulation for Early Axonal Regeneration after Nerve Surgery in Brachial Plexus Injury. J Korean Orthop Assoc. 1998. 33:501–507.

10. Yoo MC, Chung DW, Han JS, Lee KY. Surgical Treatment of Brachial Plexus Injury. J Korean Orthop Assoc. 1988. 23:1165–1173.