[Iatrogenic nerve injuries. Part 1: Frequency distribution, new aspects, and timing of microsurgical treatment].

OBJECTIVE: The aim of this study was to analyze the number and types of iatrogenic nerve injuries operated on during a 13-year period at a relatively busy nerve center.

METHOD: Retrospective analysis was done of 191 cases surgically treated because of iatrogenic nerve injuries.

RESULTS: Most iatrogenic nerve injuries occurred after surgical procedures. As a rule, symptoms and signs appeared immediately after the procedure. Single nerves most often involved were the spinal accessory nerve at the neck ( n=27), most frequently after lymph node biopsy, and the median nerve in the carpal tunnel ( n=25), usually after carpal tunnel release and most frequently after endoscopic technique. Following in frequency are the common peroneal nerve ( n=16), superficial sensory radial nerve ( n=13), genitofemoral ( n=12), and superficial peroneal and tibial nerves ( n=9 each). Clinical improvement after neurosurgical intervention appeared in 70% of cases. Frequently iatrogenic nerve lesions are referred with significant delay, that is, not during a time interval deemed appropriate for surgical intervention.

CONCLUSION: Iatrogenic nerve lesions must be recognized in a timely manner and should be operated upon as early as other traumatic nerve injuries to ensure best chances for successful recovery.