Le lesioni vascolo-nervose nei trattamenti ortopedici a livello di braccio e gomito

Abstract

Despite advances in instrumentation and technology, complications still exist in orthopaedic practice and neurologic and vascular injuries remain an inherent part of many procedures. At arm and elbow level one of the most severe, even if unfrequent, complications is a iatrogenic nerve injury, for the relevant impairment to the upper limb function in terms of motility but also of sensibility. Various surgical procedures around the elbow and arm are known to involve a risk of vascular and/or peripheral nerve lesions. At arm level one of the major risks is a radial nerve palsy during the treatment of humerus fractures. The decision on nerve exploration and its timing is still controversial. At elbow level the development of sophisticated arthroscopic procedures and the more and more frequent implant of elbow prosthesis augment the risks of neurological damage in a surgical region difficult for the proximity of important nerve structures to the surgical approaches.