Neurovascular injuries with shoulder surgery

Neurovascular injuries following shoulder surgery are uncommon; however, the potential morbidity represented by these injuries is high. Surgeons who operate on this area must have a sound knowledge of the neurovascular anatomy in order to minimise the risk of iatrogenic injury. Vascular injuries are less common than neurological injuries. Arterial injury may result in pseudoaneurysms, which may not be symptomatic for months or years from the time of injury. Venous injuries are clinically obvious during the procedure. The larger, more central veins cannot collapse, introducing the potential risk of air embolism developing. Neurological lesions are usually transient and self-limiting, affecting the brachial plexus or the axillary nerve. However, permanent injuries have occurred. Knowledge of the pathoanatomical processes is essential for both prevention and management of these injuries.