Management strategies for peripheral iatrogenic nerve lesions

For diagnostic or therapeutic reasons, various medical procedures may cause iatrogenic injury of peripheral nerves. The authors treated 82 patients for iatrogenic nerve injury between 1990 and 2000. The main reasons for iatrogenic nerve injury were surgical failure, traction or pressure lesions, hematoma, or inadequate positioning of the patient. The authors performed neurolysis in 67 cases, which included reconstruction by nerve graft in 26 patients and direct coaptation of the nerve in 3 patients. Their postoperative results emphasize the importance of early diagnosis and adequate treatment of iatrogenic peripheral nerve damage for optimal functional recovery. The authors highlight the different causes for iatrogenic injury in this study to alert surgeons as well as other medical specialists to simple strategies for avoiding nerve injury. They also indicate the need for physicians to make themselves familiar with early diagnostic steps for detecting iatrogenic injuries, like electroneurographic studies, and to document physical examinations well, to deal with this problem most effectively.