Iatrogenous Injuries

Birch, Rolfe

doi:10.1007/978-1-84882-108-8_11

Cited by 2 publications

(2 citation statements)

References 141 publications

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“…When it is not detected early or treated according to general principles, iatrogenic nerve injury can result in severe disability. Iatrogenic nerve injury is estimated to be the cause of 17–20% of all operated traumatic nerve lesions in nerve centers that treat injuries requiring surgical repair [ 27 , 28 ]. However, the estimation would be different if nonoperatively-treated nerve lesions were considered.…”

Section: Discussionmentioning

confidence: 99%

“…Causes of intraoperative direct nerve lesion include squeezing; drilling; wounding by screws; grabbing and squeezing together with the bone being repositioned; compressing the nerve by plates or retractors; tearing with surgical instruments; stretching or pinching with repositioning instruments; piercing by Kirschner wires or screws; contusing by a sudden repositioning manoeuvre or the application of excessively strong forces; coagulating with Bovie cautery or bipolar forces; transecting; burning; cementing; excising altogether with the target pathology; being injured directly or indirectly by wire cerclage; being sutured and ligated; and being stretched to non-functionality [ 27 ]. Intraoperative nerve transection occurs mainly because the nerve was not appropriately visualized, was incorrectly identified, or was mistaken for vessels.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Management of Distal Biceps Tendon Anatomical Reinsertion Complications: Iatrogenic Posterior Interosseous Nerve Palsy

et al. 2018

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BackgroundAlthough iatrogenic posterior interosseous nerve (PIN) palsy is an uncommon complication of ruptured distal biceps brachii tendon surgical anatomical reinsertion, it is the most severe complication leading to functional limitation. The present study investigated possible types of PIN palsy as a postoperative complication of anatomical distal biceps tendon reinsertion, and aimed to clinically assess patients at 2 years after its surgical treatment.Material/MethodsThe studied sample comprised 7 male patients diagnosed with an iatrogenic PIN palsies after anatomical reinsertion of the distal biceps tendon, who were referred to the reference center for management of a peripheral nervous system injury. The nerve injury was intraoperatively evaluated. The clinical assessment used the Medical Research Council (MRC) System for motor recovery, and the Quick Disability of the Arm, Shoulder, and Hand (Quick DASH) was performed before the surgical treatment of the PIN injuries and at 2 years postoperatively. In all studied cases, electromyography was performed preoperatively and postoperatively.ResultsThe comparison of the preoperative (x=1.43±0.53) and postoperative (x=4.71±0.49) results of the motor recovery of the PIN demonstrated a statistically significant improvement (p<0.001). Moreover, the results of functional assessments with the use of the Quick DASH questionnaire significantly improved (p<0.001) postoperatively (x=6.14±6.86) compared to the preoperative evaluations (x=54.29±12.05).ConclusionsThe PIN palsies as complications of the surgical anatomical reinsertion of ruptured distal biceps brachii resulted from mechanical nerve compression or direct intraoperative damage. The 2-year outcomes justified the clinical use of surgical management for iatrogenic PIN palsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical Management of Distal Biceps Tendon Anatomical Reinsertion Complications: Iatrogenic Posterior Interosseous Nerve Palsy

et al. 2018

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Iatrogenic Nerve Injuries

Antoniadis¹,

Kretschmer²,

Pedro³

et al. 2014

Deutsches Ärzteblatt International

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A thorough knowledge of the anatomy of the vulnerable nerves and of variants in their course can lessen the risk of iatrogenic nerve injury. When such injuries arise, early diagnosis and planning of further management are the main determinants of outcome. If adequate nerve regeneration does not occur, surgical revision should optimally be performed 3 to 4 months after the injury, and 6 months afterward at the latest. On the other hand, if postoperative high resolution ultrasound reveals either complete transection of the nerve or a neuroma in continuity, surgery should be performed without any further delay. If the surgeon becomes aware of a nerve transection during the initial procedure, then either immediate end-to-end suturing or early secondary management after three weeks is indicated.

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Iatrogenous Injuries

Cited by 2 publications

References 141 publications

Surgical Management of Distal Biceps Tendon Anatomical Reinsertion Complications: Iatrogenic Posterior Interosseous Nerve Palsy

Surgical Management of Distal Biceps Tendon Anatomical Reinsertion Complications: Iatrogenic Posterior Interosseous Nerve Palsy

Iatrogenic Nerve Injuries

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