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The e-mémoires of the Académie Nationale de Chirurgie

Our experience of the nervous iatrogenic lesions of the peripheral nerves

DURANDEAU A

Seance of wednesday 07 march 2012 (CHIRURGIE ORTHOPEDIQUE)

Abstract

Iatrogenic nerve injuries’ following a surgical procedure is envisaged thanks to our experience for 35 years. The most frequent lesions in the upper limb concern the accessory spinal nerve, the brachial plexus lesions after resection of underestimated nervous tumor, the lesions of the shoulder nerves, the lesions of the radial nerve and finally the lesions of the median nerve in the carpal tunnel. In the lower limb the most frequent lesion concern cutaneous lateral nerve of the thigh, the femoral nerve, the sciatic nerve after arthroplasty of the hip, the fibular common nerve at the level of the knee and the posterior tibial nerve at the level of the ankle after arthroscopy.In presence of a neurological deficit operating comment, the authors recommend a precise assessment with examination by electric exploration, and the patient should be rapidly reoperated by a specialized surgeon in peripheral nerve surgery. The nervous repair can be envisaged only after the peroperating assessment and will require a neurolysis, a suture or a nerve graft. Only a good knowledge of the anatomy has to allow avoiding them. The repair has to be made in the best conditions to limit the adverse consequences and the medico legal procedure.