Intraosseous radial nerve entrapment complicating total elbow revision

The Journal of Arthroplasty
J Zook, W G Ward

Abstract

A 43-year-old man underwent revision of a loose total elbow arthroplasty in 1995. The arthroplasty had been implanted 20 years previously for post-traumatic osteoarthritis after a gunshot wound complicated by permanent ulnar nerve palsy. The patient suffered a minimally displaced periprosthetic fracture 4 years after implantation that was treated closed. The patient subsequently developed severe loosening with bony dilation. During revision surgery, while grasping and removing the periprosthetic membrane from within the humeral medullary canal with a Kerrison rongeur, dorsiflexion of the wrist and hand occurred. Close inspection of the membrane revealed that the radial nerve was encased inside the bone. Although not divided, the traction and contusion of the nerve caused a radial nerve palsy that partially resolved by 4 years of follow-up.

References

Feb 1, 1974·Southern Medical Journal·P S Derian, A J Bibighaus
May 1, 1993·Archives of Physical Medicine and Rehabilitation·J L Kaplan, Y Challenor

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Citations

Aug 10, 2015·Archives of Orthopaedic and Trauma Surgery·Michael HacklKilian Wegmann
Apr 2, 2009·The Journal of Bone and Joint Surgery. British Volume·D HannoucheA C Masquelet
Nov 26, 2010·Journal of Shoulder and Elbow Surgery·Thomas W ThrockmortonBernard F Morrey

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