Sensory neurapraxia after distal biceps repair is not associated with patient-reported outcomes or satisfaction: a retrospective cohort study

Abstract

Cutaneous neurapraxia is the most common complication following distal biceps tendon repair (DBTR). Currently, no patient demographic factors have been implicated in its occurrence, course, or resolution. The purpose of this study is to explore various patient demographics and their association with postoperative neurapraxia. Further it investigates how mental health scores correlate with patient-reported outcomes, and whether occurrence of neurapraxia alters this association. This retrospective review evaluates a consecutive series of patients who underwent distal biceps repair with a single-incision cortical button technique. Patients with reported outcome data at a minimum of 1year (n=47) were included for analysis. Demographic data including age, sex, body mass index, diabetes, smoking status, and occurrence of neurapraxia were recorded. Patient-reported outcome measures include the American Shoulder and Elbow Surgeons-Elbow score, Single Assessment Numeric Evaluation score, Visual Analog Scale for pain, Disabilities of the Arm, Shoulder, and Hand Score, and Veterans RAND 12 (VR-12) Mental Component Score and Physical Component Score quality-of-life assessment. Postoperative neurapraxia of any duration occurred in 45% (21/47) of patients in this cohort following DBTR. Of these, 62% (13/21) reported resolution of symptoms by the latest follow-up. Mean time to resolution of neurapraxia was 148days. Patient age, body mass index, smoking history, time to surgery, tear thickness, and increasing surgeon experience across the study period were not significantly associated with the incidence or time to resolution of postoperative neurapraxia. Scores for patient satisfaction, Visual Analog Scale, American Shoulder and Elbow Surgeons, Disabilities of the Arm, Shoulder, and Hand Score, Single Assessment Numeric Evaluation, VR-12 Mental Component Score, VR-12 Physical Component Score, and flexion ROM did not differ significantly between patients with and without postoperative neurapraxia. Patient satisfaction following DBTR was not significantly associated with postoperative neurapraxia. Patient and surgical characteristics did not influence the occurrence or time to resolution of neurapraxia. The occurrence of postoperative neurapraxia did not result in significant functional limitations.