The superficial branch of the radial nerve, which innervates dorsal parts of the thumb and the back of the hand, is in or close to the field. The 1–2-mm nerve has to be preserved.

Clinical deficits: Loss of sensitivity and pain in the territory. Altogether a rare occurrence in spite of the frequent choice of this site.

The 3–4-mm ulnar nerve is situated laterally and deeply in the operative field and can hardly be overlooked. We have not encountered ulnar nerve lesions in this rare approach.

Distal to the elbow, the median nerve almost always runs separately from the brachial artery. Unlike in our patients with longitudinal incisions over or close to the brachial artery, we have seen lesions in patients who had surgery elsewhere with long transverse incisions in the cubital fossa (which are not indicated).

With the superficialization of the basilic vein in the upper arm, the ulnar and the ulnar cutaneous brachial nerves (and their branches), which run close to the vein, are involved. There are interconnections between the nerve trunks. The special care that this surgery requires to preserve the nerves makes it challenging.