Lukas Rasulić1, Andrija Savić2, Filip Vitošević3, Miroslav Samardžić4, Bojana Živković2, Mirko Mićović4, Vladimir Baščarević4, Vladimir Puzović5, Boban Joksimović2, Nenad Novakovic6, Milan Lepić6, Stefan Mandić-Rajčević7. 1. School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: lukas.rasulic@gmail.com. 2. Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia. 3. Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, Belgrade, Serbia. 4. School of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia. 5. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. 6. Clinic for Neurosurgery, Military Medical Academy, Belgrade, Serbia. 7. Innovation Centre of Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND: Iatrogenic nerve injuries are nerve injuries caused by medical interventions or inflicted accidentally by a treating physician. METHODS: We 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. RESULTS: The 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. CONCLUSIONS: Patients 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.
BACKGROUND:Iatrogenic nerve injuries are nerve injuries caused by medical interventions or inflicted accidentally by a treating physician. METHODS: We 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. RESULTS: The 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. CONCLUSIONS:Patients 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.
Authors: Lukas Rasulić; Slavko Djurašković; Novak Lakićević; Milan Lepić; Andrija Savić; Jovan Grujić; Aleksa Mićić; Stefan Radojević; Vladimir Puzović; Miloš Maletić; Stefan Mandić-Rajčević Journal: Front Surg Date: 2021-12-16
Authors: Lukas Rasulić; Slavko Đjurašković; Novak Lakićević; Milan Lepić; Andrija Savić; Jovan Grujić; Aleksa Mićić; Stefan Radojević; María Elena Córdoba-Mosqueda; Jacopo Visani; Vladimir Puzović; Vojin Kovačević; Filip Vitošević; Stefan Mandić-Rajčević; Saša Knezevic Journal: Front Surg Date: 2022-09-20