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Neurologic complications in common wrist and hand surgical procedures

Nicole Verdecchia, Julie Johnson, Mark Baratz, Steven Orebaugh
  • Nicole Verdecchia
    Department of Anesthesiology, University of Pittsburgh Medical Center, PA, United States | verdecchianm@upmc.edu
  • Julie Johnson
    Department or Orthopedic Surgery, University of Pittsburgh Medical Center, PA, United States
  • Mark Baratz
    Department or Orthopedic Surgery, University of Pittsburgh Medical Center, PA, United States
  • Steven Orebaugh
    Department of Anesthesiology, University of Pittsburgh Medical Center, PA, United States

Abstract

Nerve dysfunction after upper extremity orthopedic surgery is a recognized complication, and may result from a variety of different causes. Hand and wrist surgery require incisions and retraction that necessarily border on small peripheral nerves, which may be difficult to identify and protect with absolute certainty. This article reviews the rates and ranges of reported nerve dysfunction with respect to common surgical interventions for the distal upper extremity, including wrist arthroplasty, wrist arthrodesis, wrist arthroscopy, distal radius open reduction and internal fixation,carpal tunnel release, and thumb carpometacarpal surgery. A relatively large range of neurologic complications is reported, however many of the studies cited involve relatively small numbers of patients, and only rarely are neurologic complications included as primary outcome measures. Knowledge of these neurologic outcomes should help the surgeon to better counsel patients with regard to perioperative risk, as well as provide insight into workup and management of any adverse neurologic outcomes that may arise.

Keywords

Wrist, hand, thumb, surgery, neurologic, complication, outcome

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Submitted: 2017-12-11 11:21:05
Published: 2018-03-29 15:17:14
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Copyright (c) 2018 Nicole Marie Verdecchia, Julie Johnson, Mark Baratz, Steven Orebaugh

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