• World Neurosurg · Jul 2017

    Iatrogenic Peripheral Nerve Injuries - Surgical Treatment and Outcome: 10-Years´ Experience.

    • Lukas Rasulić, Andrija Savić, Filip Vitošević, Miroslav Samardžić, Bojana Živković, Mirko Mićović, Vladimir Baščarević, Vladimir Puzović, Boban Joksimović, Nenad Novakovic, Milan Lepić, and Stefan Mandić-Rajčević.
    • School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: lukas.rasulic@gmail.com.
    • World Neurosurg. 2017 Jul 1; 103: 841-851.e6.

    BackgroundIatrogenic nerve injuries are nerve injuries caused by medical interventions or inflicted accidentally by a treating physician.MethodsWe describe and analyze iatrogenic nerve injuries in a total of 122 consecutive patients who received surgical treatment at our Institution during a period of 10 years, from January 1, 2003, to December 31, 2013. The final outcome evaluation was performed 2 years after surgical treatment.ResultsThe most common causes of iatrogenic nerve injuries among patients in the study were the operations of bone fractures (23.9%), lymph node biopsy (19.7%), and carpal tunnel release (18%). The most affected nerves were median nerve (21.3%), accessory nerve (18%), radial nerve (15.6%), and peroneal nerve (11.5%). In 74 (60.7%) patients, surgery was performed 6 months after the injury, and in 48 (39.3%) surgery was performed within 6 months after the injury. In 80 (65.6%) patients, we found lesion in discontinuity, and in 42 (34.4%) patients lesion in continuity. The distribution of surgical procedures performed was as follows: autotransplantation (51.6%), neurolysis (23.8%), nerve transfer (13.9%), direct suture (8.2%), and resection of neuroma (2.5%). In total, we achieved satisfactory recovery in 91 (74.6%), whereas the result was dissatisfactory in 31 (25.4%) patients.ConclusionsPatients with iatrogenic nerve injuries should be examined as soon as possible by experts with experience in traumatic nerve injuries, so that the correct diagnosis can be reached and the appropriate therapy planned. The timing of reconstructive surgery and the technique used are the crucial factors for functional recovery.Copyright © 2017 Elsevier Inc. All rights reserved.

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