Iatrogenic peripheral nerve injuries – Common causes and treatment: A retrospective single-center cohort study

BACKGROUND:Iatrogenic nerve injuries can result from surgical damage. Thus, physicians should be aware of the risk factors and procedures that need to be followed in such patients. The purpose of this study was to examine data pertaining to patients with known iatrogenic nerve injuries and to elucidate the detailed causes of these injuries, the affected nerves, and the type of surgical procedures for treatment. METHODS:This retrospective study included 232 consecutive patients who underwent surgical treatment for peripheral nerve palsy or nerve injury between 2006 and 2017 at our hospital. Among the 232 patients investigated, we identified 51 cases with iatrogenic nerve injuries (23 women and 28 men; mean age, 51.3 years). Among the 51 patients, 45 were referred from other hospitals, and the remaining were from our hospital. Data were summarized using descriptive statistics. RESULTS:Direct surgical damage occurred in 94% (48/51) of patients with iatrogenic nerve injuries. Such injuries mostly developed after surgery for bone fractures (33%), resection of soft tissue tumors (22%), and carpal tunnel release procedures (20%). The nerves most commonly affected in such procedures are the radial nerve (26%), median nerve (24%), and ulnar nerve (17%). The median interval of referral to our hospital after nerve injury was 5.1 months. The median interval of surgery to correct the injury was 7 months. Surgeries to correct iatrogenic nerve injuries performed at our hospital included neurolysis (55%), nerve grafts (29%), direct suture procedures (10%), and tendon transfers (6%). CONCLUSIONS:We believe that wide dissemination of the results obtained in this study will reduce the incidence of iatrogenic peripheral nerve injuries and increase the speed of referrals to specialized centers.