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Management of Iatrogenic Nerve Injuries

Pulos, Nicholas MD; Shin, Emily H. MD; Spinner, Robert J. MD; Shin, Alexander Y. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: September 15, 2019 - Volume 27 - Issue 18 - p e838-e848
doi: 10.5435/JAAOS-D-18-00510
Review Article

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.

From 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).

Dr. Pulos or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Trimed. Dr. Spinner or an immediate family member serves as a paid consultant to Mayo Medical Ventures. Dr. A. Y. Shin or an immediate family member has received IP royalties from Mayo Medical Ventures and Trimed. Neither Dr. E. H. Shin nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Copyright 2019 by the American Academy of Orthopaedic Surgeons.
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