Neurologic complications of surgery for anterior shoulder instability

Two-hundred eighty-two patients underwent anterior reconstruction for recur rent glenohumeral instability between 1981 and 1991. Twenty-three patients (8.2%) had a neurologic deficit after surgery. Seven had sensory disturbanc es only; 16 had sensorimotor neuropathies (8 having multiple deficits desig nated as a diffuse plexopathy and 8 having a more defined deficit in 1 or 2 cords or peripheral nerves). Complete resolution occurred in 18 of the 23 patients. Four patients had a residual deficit (1 patient was lost to follo wup). Three had persistent sensory disturbances; 1 had permanent biceps wea kness. None of these patients underwent surgical exploration. Older age (P = .045) and a Bankart lesion (P = .029) were associated with a neurologic c omplication. At an average follow-up of 8.7 years, 252 patients responded t o a questionnaire regarding shoulder outcome, including 20 of the 23 patien ts with nerve injuries. The difference in the median Rowe score of those wi th and without nerve injury was not significant (P = .072). Neurologic inju ries after anterior shoulder surgery presumably arise as a result of tracti on. The prognosis for neurologic recovery is generally good. Neurologic inj ury did not interfere with the outcome of the stabilization procedure.