Iatrogenic upper limb nerve injuries: a systematic review

Zhang, Junyi; Moore, Abigail E.; Stringer, Mark D.

doi:10.1111/j.1445-2197.2010.05597.x

Cited by 90 publications

(62 citation statements)

References 81 publications

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“…30 While most injuries occurred during a carpal tunnel release, 3,18 median nerve injuries have been known to occur with elbow arthroscopic procedures 14 and steroid injections into the carpal tunnel. 4,10,11 In most cases, the injuries are partial, although complete transections of the median nerve have also been reported.…”

Section: Discussionmentioning

confidence: 99%

“…In a literature review of iatrogenic upper limb nerve injuries, 30 the median nerve was the most common upper limb nerve injury requiring surgical repair, accounting for 16% of cases. The majority of the reported injuries occurred during the surgical treatment of carpal tunnel syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…The majority of the reported injuries occurred during the surgical treatment of carpal tunnel syndrome. 3,18,30 The palmaris longus is an accepted donor tendon for transfer and grafting. At the level of the wrist, the palmaris longus tendon lies immediately superficial to the median nerve.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest

Choo

Wilhelmi

Kasdan

2016

Hand (New York, N,Y.)

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Background: A rare and disastrous complication of harvesting a tendon graft is the misidentification of the median nerve for the palmaris longus. Methods: The authors report a referred case in which the median nerve was harvested as a free tendon graft. Results: Few reports of this complication are found in the literature despite the frequency of palmaris longus tendon grafting and the proximity of the palmaris tendon to the median nerve. Given the obvious medicolegal implications, the true incidence of this complication is difficult to assess. Discussion: Safe harvesting of the palmaris longus mandates a thorough understanding of the relevant anatomy, in particular the proper differentiation between nerve and tendon and recognition of when the palmaris longus tendon is absent. Techniques to facilitate proper identification of the palmaris longus are outlined.Keywords: median nerve injury, iatrogenic nerve injury, palmaris longus anatomy, median nerve anatomy, safe techniques for palmaris longus harvest

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest

Choo

Wilhelmi

Kasdan

2016

Hand (New York, N,Y.)

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“…In another side of traction, brachial plexus injuries have been reported in cardiac surgery, orthopedic, Schwannoma and general surgery as well as breast reconstruction. 13,14 There is a wide variety of distribution of paralysis from BPI. It can occur due to differentiation of topography from each branch of nerve and the process of injury.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Patient with Brachial Plexus Injury in Neurophysiology Laboratory of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2003 to 2012

Kurnianto

Kurniani

Soenggono

2015

amj

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Background: Brachial plexus is a network of nerves that controls the upper limb. Unfortunately, it can be injured easily which is called brachial plexus injury (BPI). It can cause disability. Until now, the epidemiology of BPI in Indonesia is still lacking. The aim of this study was to describe the characteristics of patients with BPI in Bandung, in order to increase knowledge and attention of health care provider and community to prevent BPI. Methods: This was a descriptive retrospective study. Data from medical records of patients with BPI who underwent electromyography (EMG) in Neurophysiology Laboratory Dr. Hasan Sadikin General Hospital, Bandung from 2003 to 2012 were collected. The data included age, sex, mode of injury, affected side and distribution of paralysis. Collected data were presented as percentages shown in tables. Results: A total of 91 cases were collected during study period, which consisted of 69 males and 22 females (76% vs. 24%). Most of them were in productive age group (11−20 years and 21−30 years). The main cause of brachial plexus injury was traffic accident (76%), followed by birth injury. Distribution of paralysis was mostly in postganglionic area of cervical (C)5, C6, C7, C8 and thoracal (T)1 (67%). Around two third of the cases involved the right side of upper limb. Conclusions:The study showed that most of patients with BPI are male in their productive ages. Traffic accident is the most common cause, and the most affected side is the right side of upper limb.

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“…[19][20][21][22] Furthermore, such practical knowledge of clinical anatomy and anatomical structures may also assist in the prevention of injuries to patients, such as iatrogenic nerve injuries that are suffered by patients who are incorrectly positioned or moved during surgery. [23] Diagnosis and assessment In New Zealand, nurses transition to registered Nurse Practitioners under the regulations and postgraduate qualifications established by the New Zealand Nursing Council. Included within the definition of the nurse practitioner scope of practice is the statement that 'They provide a wide range of assessment and treatment interventions including differential diagnoses, .... for the management of potential or actual health needs.'…”

Section: Occupational Health and Safetymentioning

confidence: 99%

The availability of clinical anatomy in postgraduate nursing education in New Zealand

Cornwall¹,

Robinson²,

Sika-Paotonu³

2016

Anatomy

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Objectives: Clinical anatomy is a vital subject for postgraduate training for many healthcare professions. Nurses undertaking advanced training require knowledge of clinical anatomy to guide sound clinical practice (assessment, differential diagnosis, decision-making processes) and professional interaction. The availability of clinical anatomy for nurses at postgraduate level in New Zealand was assessed to provide insight into local educational trends.Methods: An audit of institutions offering postgraduate nursing education in New Zealand (five universities, four polytechnics) was performed. The availability of clinical anatomy and other science-based courses were assessed to explore science education options. Institution and departmental websites were accessed to determine course availability for clinical anatomy and science-based (pathophysiology, pharmacology) courses; telephone communication was initiated when data were unclear and to confirm course availability. Basic descriptive analyses were performed on data.Results: On average, 26.3 different courses were offered per institution (range 7 to 39; total 237). From the nine institutions offering postgraduate nursing training, fifteen science-based courses were available. One institution offered no basic science courses, all others offered either pharmacology (n=10), pathophysiology (n=5) or both (n=5). Two offered two pharmacology courses. No institutions offered clinical anatomy. Conclusion:The lack of clinical anatomy training options in postgraduate nursing education in New Zealand suggests this subject may be perceived as not relevant. The relevance of clinical anatomy to postgraduate nursing education is discussed to highlight how this important subject would assist educational outcomes, and to provide impetus for its implementation in future programmes.

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Iatrogenic upper limb nerve injuries: a systematic review

Abstract: Some iatrogenic upper limb peripheral nerve injuries may be unavoidable, but most cases are probably preventable by an adequate knowledge of surgical anatomy and an awareness of the types of procedures in which peripheral nerves are particularly vulnerable.

Cited by 90 publications

References 81 publications

Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest

Iatrogenic Injury to the Median Nerve During Palmaris Longus Harvest

Characteristics of Patient with Brachial Plexus Injury in Neurophysiology Laboratory of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2003 to 2012

The availability of clinical anatomy in postgraduate nursing education in New Zealand

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