Injury to the lateral cutaneous nerve of forearm after venous cannulation: a case report and literature review.
Venepuncture may be associated with nerve injuries and is commonly performed at the median cubital vein (MCV). Injuries to the superficial radial nerve at the wrist and to the median nerve, anterior and posterior interosseus nerves and medial and lateral cutaneous nerves (LCN) of the forearm at the cubital fossa have been reported. The LCN is a sensory branch of the musculocutaneous nerve and the position of the nerve in relation to the MCV is variable within the cubital fossa. The LCN supplies sensory innervation to the C6 dermatome corresponding to an area of skin overlying the radial border of the forearm. We report the case of a 30-year-old right-handed woman who presented with loss of sensation in the left forearm after donating blood at a transfusion centre. This was due to an injury of the LCN. After 3, 18 and 36 months of follow-up, the sensory deficit had only improved minimally. The lack of recovery of the sensation after 36 months indicates a permanent nerve injury such as neurotmesis rather than neurapraxia of the LCN. A thorough knowledge of the clinical anatomy of the MCV and the LCN, which is highlighted, is essential in preventing venepuncture-associated nerve injury.
Department of Plastic and Reconstructive Surgery, St George's Hospital, London, United Kingdom. rjgs@doctors.org.uk
R J G
RJ
Stevens
V
V
Mahadevan
A L H
AL
Moss
D000328:Adult; D001782:Blood Donors; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply* / Q000294:innervation*; D006801:Humans; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000209:etiology*; D020127:Recovery of Function; D012677:Sensation; D013997:Time Factors