Inadvertent Harvest of the Median Nerve Instead of the Palmaris Longus Tendon.

Content Provider	Semantic Scholar
Author	Leslie, Bruce M. Osterman, Arthur Lee Wolfe, Scott W.
Copyright Year	2017
Abstract	BACKGROUND The palmaris longus tendon is frequently used as a tendon graft or ligament replacement. In rare instances the median nerve has been inadvertently harvested instead of the palmaris longus for use as a tendon. METHODS Nineteen cases in which the median nerve had been mistakenly harvested instead of the palmaris longus tendon were collected from members of the American Society for Surgery of the Hand (ASSH) Listserve. Surgeons involved in the subsequent care of the subject who had had an inadvertent harvest were contacted or the chart was reviewed. The reason for the initial procedure, the skill level of the primary surgeon, and when the inadvertent harvest was recognized were documented. When possible, the method of harvest and subsequent treatment were also documented. RESULTS The most common initial procedure was a reconstruction of the elbow ulnar collateral ligament, followed by basal joint arthroplasty, tendon reconstruction, and reconstruction of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Only 7 of the inadvertent harvests were recognized intraoperatively; in the remaining 12 cases the nerve was used as a tendon graft. The sensory loss was not recognized as being due to the inadvertent harvest until the first postoperative visit (2 subjects), 3 to 4 weeks (2 subjects), 2 to 3 months (2 subjects), 5 to 7 months (2 subjects), 1 year (1 subject), 3 years (1 subject), or 10 years (1 subject). Preoperative clinical identification of the presence or absence of a palmaris longus did not necessarily prevent an inadvertent harvest. CONCLUSIONS Knowledge of the relevant anatomy is crucial to avoiding inadvertent harvest of the median nerve instead of the palmaris longus tendon.
Starting Page	1173
Ending Page	1182
Page Count	10
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.nwoa.com/wp-content/uploads/2017/07/Inadvertent_Harvest_of_the_Median_Nerve_Instead_of.3-2.pdf
PubMed reference number	28719556v1
Alternate Webpage(s)	https://doi.org/10.2106/JBJS.16.01218
DOI	10.2106/JBJS.16.01218
Journal	The Journal of bone and joint surgery. American volume
Volume Number	99
Issue Number	14
Language	English
Access Restriction	Open
Subject Keyword	Abducens Nerve Diseases Anatomic structures Arthroplasty Document completion status - Documented Hereditary Sensory and Autonomic Neuropathy Type Ie Ligaments Metacarpophalangeal joint structure Primary Surgeon - Procedure Practitioner Identifier Code Type Rupture of Achilles tendon Structure of collateral carpal ulnar ligament Structure of collateral ligament Structure of median nerve Structure of palmaris longus muscle Tendon structure Transplanted tissue
Content Type	Text
Resource Type	Article