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).
J Am Acad Orthop Surg. 2019 Sep 15;27(18):e838-e848. doi: 10.5435/JAAOS-D-18-00510.
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.
医源性周围神经损伤可由多种情况引起，包括手术时直接损伤神经、通过牵拉或间隔综合征间接损伤神经，以及注射和夹板等非手术治疗引起的损伤。医源性神经损伤的成功管理需要准确的诊断和及时、适当的治疗。所有骨科医生都必须了解神经损伤的临床前研究以及医源性神经损伤的评估和治疗选择。虽然在手术室直视下可以立即修复明显切断的神经，但许多损伤要到术后才能发现。诊断研究和神经修复技术、神经移植和神经转移的进步提高了我们识别和治疗这些损伤的能力。
