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Management of Iatrogenic Nerve Injuries
Nicholas Pulos1, Emily H Shin, Robert J Spinner
1From the Division of Hand Surgery, Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (Dr. Pulos, Dr. Spinner, and Dr. A. Y. Shin), the Department of Orthopaedic Surgery, Madigan Army Medical Center, Joint Base Lewis-McChord, WA (Dr. E. H. Shin), and the Department of Neurosurgery, Mayo Clinic, Rochester, MN (Dr. Spinner).
Abstract:
Iatrogenic peripheral nerve injuries from orthopaedic surgery can occur via many scenarios, including direct injury to the nerve during surgery, indirect injury via retraction or compartment syndrome, and injury from nonsurgical treatments such as injections and splinting. Successful management of iatrogenic nerve injuries requires an accurate diagnosis and timely, appropriate treatment. All orthopaedic surgeons must understand the preclinical study of nerve injury and the evaluation and treatment options for iatrogenic nerve injuries. Although a sharply transected nerve can be repaired immediately in the operating room under direct visualization, many injuries are not appreciated until the postoperative period. Advances in diagnostic studies and nerve repair techniques, nerve grafting, and nerve transfers have improved our ability to identify and treat such injuries.
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