The radial nerve at revision/ redo surgery – Using the lower lateral cutaneous nerve to prevent a post op radial nerve deficit

Abstract

Abstract Introduction The posterior approach to the Humeral shaft is commonly utilized for surgical procedures on the Humeral shaft. We present our experiences utilizing the Gerwin M. modification of the surgical exposure which we have found useful at the time of revision surgery. Patients and methods Between 2014 and 2019 six patients who underwent a revision surgical procedure for a non-union of the humeral shaft where a prior surgical procedure was performed through a posterior incision were included. The approach utilized a modification of the posterior approach described by Gerwin M. where the lower lateral cutaneous nerve branch of the radial nerve is used to identify trace, mobilize, retract and protect the radial nerve to achieve adequate exposure of the humeral shaft. Results and Discussion : None of the patients had a postoperative nerve deficit. Adequate exposure to aid hardware removal, osteosynthesis and bone grafting was achieved in all patients. None of the patients had a postoperative nerve deficit. Conclusion The Gerwin M. modification of the posterior approach is useful at the time of revision or redo surgery on the humeral shaft where other bony and soft tissue landmarks are altered to prevent an iatrogenic injury to the radial nerve while providing adequate exposure to treat a nonunion.