• John Zhang, Abigail E Moore, and Mark D Stringer.
• Department of Anatomy & Structural Biology, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand.
• ANZ J Surg. 2011 Apr 1;81(4):227-36.

PurposePeripheral nerve injuries are among the most frequent iatrogenic complications and are responsible for considerable morbidity and litigation. Most occur within surgical settings and upper limb nerves are most frequently involved.MethodsA systematic review of major iatrogenic upper limb nerve injuries was undertaken to evaluate the contemporary spectrum of such injuries. The electronic databases MEDLINE, PubMed, Cochrane Library and Google Scholar were searched for relevant articles listed between January 2000 and May 2010. Iatrogenic injuries to the brachial plexus, radial, axillary, ulnar, median, musculocutaneous and major cutaneous nerves were analysed, focusing on context, mechanisms of injury and incidence.ResultsIatrogenic upper limb nerve injuries are relatively common and can affect patients in any surgical specialty. Even patients undergoing diagnostic procedures under general anaesthesia are at risk. Orthopaedic surgery and plastic and reconstructive surgery figure prominently in these complications. The spectrum of iatrogenic peripheral nerve injuries has changed in parallel with technological advances in surgery, anaesthesia and medicine.ConclusionsSome 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.© 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

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