Iatrogenic nerve injury in upper limb surgery excepting shoulder

Area of Science:

• Orthopedics
• Neurology
• Surgical Safety

Background:

• Upper limb nerve injuries, though infrequent, are a significant cause of patient morbidity and medicolegal complications.
• These injuries can arise during patient positioning, regional anesthesia, or surgical procedures.
• Understanding these risks is crucial for patient safety in orthopedic and neurological surgery.

Purpose of the Study:

• To synthesize the mechanisms of upper limb nerve injuries.
• To identify nerves at risk across different anatomical regions (arm to hand).
• To outline preventive measures and a diagnostic/therapeutic approach for iatrogenic nerve injuries.

Main Methods:

• Review of mechanisms leading to upper limb nerve injuries.
• Anatomical regional analysis of nerves at risk.
• Synthesis of preventive strategies and clinical management guidelines.

Main Results:

• Nerve injuries can occur during patient positioning, anesthesia, or surgery.
• Specific nerves are vulnerable depending on the anatomical region and procedure.
• Knowledge of anatomical landmarks and safety zones is key to prevention.

Conclusions:

• Implementing simple preventive measures can significantly reduce iatrogenic risk.
• Awareness and education, especially for junior practitioners, are vital.
• A structured approach to diagnosis and treatment is necessary for suspected postoperative nerve injuries.