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American Association for Hand Surgery
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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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Differences in Complications of Elbow Arthroscopy Between Adult and Pediatric Patients
Jessica M Intravia, MD, MHA1; Daniel P Acevedo, MD2; Joanie J Chung, MPH, MA2; Raffy Mirzayan, MD2
1University of Southern California, Los Angeles, CA; 2Kaiser Permanente, Baldwin Park, CA

Introduction: There are few large studies documenting the complications of elbow arthroscopy, especially one representative of the community orthopaedic surgeon.

Methods: After IRB approval, 560 consecutive elbow arthroscopies in 528 patients performed between 2006 and 2014, by 42 surgeons at 13 facilities were reviewed. There were 114 pediatric cases and 446 adult cases. Patient demographics, BMI, smoking status, medical co-morbidities, tourniquet time, prior surgery, concomitant procedures, patient positioning, size of scope, complexity score, range of motion, and surgeon fellowship status were recorded. Complications including nerve injury, vascular injury, re-operation, re-hospitalization, infection, heterotopic ossification, compartment syndrome and DVT/PE were recorded.

Results: The average age was 38.6 years (range: 5-88). There were 444 males. The average length of follow up was 375.8 days (0-2739 days). Overall, heterotopic ossification occurred in 14 of 559 (2.5%) cases, and 20 of 559 (3.5%) cases developed transient nerve palsies (8 ulnar, 8 radial, 1 median, 3 medial antebrachial cutaneous). There were 3 deep infections and 11 superficial infections (2.5%). There were no cases of vascular injury, compartment syndrome, deep vein thrombosis, or pulmonary embolism. Previous elbow surgery (OR 3.57, P=0.006) and female gender (OR4.05; P=0.002) were significant risk factors for nerve injury. Overall, diabetes/pre-diabetes had a significantly higher risk for infection (OR 4.11, P=0.0136). There were no infections in patients who were smokers or those who had a steroid injection at completion of case.

Conclusions: Elbow arthroscopy remains a safe procedure with very low complication rates. There were higher complications in adults relative to pediatric patients, but they did not reach significance.


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