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Iatrogenic nerve injury

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https://www.readbyqxmd.com/read/29644301/pseudoaneurysm-of-brachial-artery-a-rare-cause-of-median-nerve-compression
#1
João Lobo, Mariana Cunha Ferreira, Pedro Negrão Ramos
Background: The authors present an unusual clinical case of high median nerve compression caused by an iatrogenic pseudoaneurysm of the brachial artery after an angiography with a follow up of 9 months. Methods: A 73-year-old male was seen with progressive numbness, loss of opponency and diminution of strength of finger flexion in the left hand after an angiography with direct puncture of the left humeral artery. Physical examination revealed a hard consistency internal distal arm swelling with the size of a walnut, non-pulsatile and with a Tinel sign on percussion...
April 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644106/supraorbital-nerve-exits-positional-variations-and-localization-relative-to-surgical-landmarks
#2
Deepthi Nanayakkara, Ruwanthi Manawaratne, Harshana Sampath, Amal Vadysinghe, Roshan Peiris
Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture...
March 2018: Anatomy & Cell Biology
https://www.readbyqxmd.com/read/29642947/absence-of-flexor-carpi-radialis-identified-during-volar-approach-for-fixation-of-distal-radius-fracture-a-case-report
#3
Tomoyo Irie, Makoto Motomiya, Norimasa Iwasaki
BACKGROUND: Volar locking plate fixation of distal radius fractures is commonly performed because of its good clinical outcomes. The flexor carpi radialis (FCR) approach is one of the most popular approaches to dissecting the volar side of the distal radius because of its simplicity and safety. We describe an extremely rare case of an absent FCR identified during a volar approach for fixation of a distal radius fracture. CASE PRESENTATION: A 59-year-old woman with distal radius fracture underwent surgery using the usual FCR approach and volar locking plate...
April 11, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29628712/best-care-paradigm-to-optimize-functionality-after-extra-articular-distal-humeral-fractures-in-the-young-patient
#4
REVIEW
Mark S Ayoub, Ivan S Tarkin
For younger patients with extra-articular distal humerus fractures closed management is plagued with high rates of malunion, suboptimal functional outcomes, extended immobilization with loss of early motion, a delay in return to work, and a general period of lost productivity. Surgical management offers an appealing alternative. Maintaining respect for the triceps musculature and minimizing iatrogenic injury to the radial nerve are primary concerns with operative treatment. Accordingly, use of a triceps-sparing approach and single column plating may be the optimal treatment paradigm in the young patient presenting with an extra-articular distal humerus fracture...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29615086/comparison-of-lateral-entry-with-crossed-entry-pinning-for-pediatric-supracondylar-humeral-fractures-a-meta-analysis
#5
Yuyan Na, Rui Bai, Zhenqun Zhao, Changxu Han, Lingyue Kong, Yizhong Ren, Wanlin Liu
BACKGROUND: The standard treatment for severe displaced pediatric supracondylar humeral fracture (SCHF) is closed reduction and percutaneous pin fixation. However, controversy persists concerning the optimal pin fixation technique. The purpose of this study was to compare the safety and efficacy on the configuration of lateral entry only with crossed entry pin fixation for SCHF, including Gartland type II and type III fractures in children. METHODS: Published literatures, including retrospective studies, prospective studies, and randomized controlled trials, presenting the probability of poor functional consequence of elbow and/or loss of reduction and/or iatrogenic ulnar nerve injury and/or superficial infection and/or cubitus varus were included...
April 3, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29610114/two-cases-of-unidentified-acute-compartment-syndrome
#6
Shinsuke Takeda, Masahiro Tatebe, Atsushi Sakai, Hitoshi Hirata
Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological malignancies. Both patients complained of severe pain and swelling of their extremity. No bite marks, blisters or skin necrosis was noted. They also complained of marked symptoms of third cranial nerve injury, including divergent squint and diplopia...
April 1, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29601408/microanatomical-nerve-architecture-of-6-mammalian-species-is-trans-species-translational-anatomic-extrapolation-valid
#7
Anna Server, Miguel A Reina, André P Boezaart, Alberto Prats-Galino, Marielle Esteves Coelho, Xavier Sala-Blanch
BACKGROUND AND OBJECTIVES: Various animal models have historically been used to study iatrogenic nerve injury during performance of conduction nerve blocks. Our aims were to compare the microstructures of nerves in commonly used species to those of humans and to explore the validity of the extrapolating these findings to humans. METHODS: High-resolution, light-microscopic images were obtained from cross sections of sciatic nerves at their bifurcation from fresh rat, rabbit, pig, sheep, dog, and human cadavers...
March 29, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29595737/surgical-approach-to-injuries-of-the-cervical-plexus-and-its-peripheral-nerve-branches
#8
David L Brown, A Lee Dellon
BACKGROUND: Located in the neck beneath the sternocleidomastoid muscle, the cervical plexus comprises a coalition of nerves originating from C1 through C4, which provide input to four cutaneous, seven motor, and three cranial nerves and the sympathetic trunk. Sporadic instances of injury to these superficial nerves have been reported. Nevertheless, this specific anatomical cause of neurogenic pain remains incompletely described and underrecognized. METHODS: Twelve patients presented with pain and were diagnosed with various combinations of injury to the lesser occipital, great auricular, transverse cervical, and supraclavicular nerves...
April 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29564052/anatomical-relationships-between-muscles-overlying-distal-transverse-carpal-ligament-and-thenar-motor-branch-of-the-median-nerve
#9
Midum Jegal, Sung Jong Woo, Hyun Il Lee, Jae Woo Shim, Woo Jin Shin, Min Jong Park
Background: The purpose of the current study is to investigate anatomical relationships between the muscle overlying the distal transverse carpal ligament (TCL) and the thenar motor branch of the median nerve. Methods: Of the 192 wrists that underwent open carpal tunnel release, a muscle belly overlying the TCL was observed on the distal margin of TCL in 25 wrists and ligament exposure could not be achieved without transection of it. We recorded surgical findings of these 25 wrists...
March 2018: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29557227/surgical-management-of-proximal-fibular-tumors-risk-factors-for-recurrence-and-complications
#10
Changzhi Guo, Xiaoran Zhang, Feng Gao, Lingxiang Wang, Tao Sun
Objectives The aim of this study was to identify patient- and treatment-specific independent risk factors for the recurrence of proximal fibular tumors and complications of their surgical management. Methods Patients who underwent surgical treatment of proximal fibular tumors at our institution from 2004 to 2015 were retrospectively reviewed. All patients had a pathologically confirmed diagnosis and were followed up for at least 12 months for recurrence and complications. All patients were evaluated with respect to seven patient-, disease-, and treatment-specific variables...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29552483/a-percutaneous-knotless-technique-for-acute-achilles-tendon-ruptures
#11
Daniel J Liechti, Gilbert Moatshe, Jonathon D Backus, Daniel Cole Marchetti, Thomas O Clanton
Achilles tendon ruptures are a common tendon injury, usually occurring in middle-aged men during recreational sporting activities. Both nonoperative and operative management are employed to treat these injuries. Several operative treatments are described in the literature, including percutaneous Achilles repair, mini-open repair, and open repair. Open Achilles repair is associated with higher rates of impaired wound healing and infection, whereas minimally invasive techniques have been reported to have an increased risk of iatrogenic sural nerve injury...
February 2018: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29549379/a-review-of-main-anatomical-and-sonographic-features-of-subcutaneous-nerve-injuries-related-to-orthopedic-surgery
#12
REVIEW
Anne Causeret, Isabelle Ract, Jérémy Jouan, Thierry Dreano, Mickaël Ropars, Raphaël Guillin
Lesion to subcutaneous nerves is a well-known risk of orthopedic surgery and a significant cause of postoperative pain and dissatisfaction in patients. High-resolution ultrasound can be used to visualize the vast majority of small subcutaneous nerves of the upper and lower limbs. Ultrasound detects nerve abnormalities such as focal hypoechoic thickening, stump neuroma, and scar encasement, and provides information not only about the peripheral nerve itself but also about its relationship to adjacent anatomical structures...
March 16, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29525901/perianal-minimally-invasive-surgery-pamis-for-rectal-stump-resection-after-previous-colectomy
#13
Andreas Lorenz, Pamela Kogler, Marcus Huth, Reinhold Kafka-Ritsch, Dietmar Öfner, Alexander Perathoner
PURPOSE: Resection of a long rectal stump after previous colectomy or Hartmann procedure often requires a combined transperitoneal and transperineal approach because of limited access through a perineal incision alone. Risks associated with this procedure include iatrogenic injury to bowels, nerves, ureters, vessels and sexual organs. This study reports on the feasibility and safety of perianal minimally invasive surgery (PAMIS) for the resection of long rectal stumps that would otherwise require a combined transperitoneal and perianal approach...
March 10, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29525026/hip-arthroscopy-common-problems-and-solutions
#14
REVIEW
Aaron Casp, Frank Winston Gwathmey
The use of hip arthroscopy continues to expand. Understanding potential pitfalls and complications associated with hip arthroscopy is paramount to optimizing clinical outcomes and minimizing unfavorable results. Potential pitfalls and complications are associated with preoperative factors such as patient selection, intraoperative factors such as iatrogenic damage, traction-related complications, inadequate correction of deformity, and nerve injury, or postoperative factors such as poor rehabilitation. This article outlines common factors that contribute to less-than-favorable outcomes...
April 2018: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/29523381/iatrogenic-trigeminal-post-traumatic-neuropathy-a-retrospective-two-year-cohort-study
#15
Y Klazen, F Van der Cruyssen, M Vranckx, M Van Vlierberghe, C Politis, T Renton, R Jacobs
With the growing demand for dental work, trigeminal nerve injuries are increasingly common. This retrospective cohort study examined 53 cases of iatrogenic trigeminal nerve injury seen at the Department of Oral and Maxillofacial Surgery, University Hospitals of Leuven between 2013 and 2014 (0.6% among 8845 new patient visits). Patient records were screened for post-traumatic trigeminal nerve neuropathy caused by nerve injury incurred during implant surgery, endodontic treatment, local anaesthesia, tooth extraction, or specifically third molar removal...
March 6, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29521936/quantifying-the-location-of-the-radial-nerve-in-children-for-intraoperative-use
#16
Ena Nielsen, Lindsay M Andras, David L Skaggs
BACKGROUND: In adults, a relative "safe zone" for lateral approaches to the elbow has been well described in efforts to reduce iatrogenic injury, typically a minimum of 6 cm proximal to the lateral epicondyle. To avoid iatrogenic injury to the radial nerve intraoperatively, we investigated the distance of the nerve from the distal humeral physis in children. METHODS: All patients who had axial and coronal T1-weighted magnetic resonance imagings of the humerus and elbow between 2005 and 2015 were eligible...
March 8, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29521743/painful-neuroma-treatment-of-the-supraorbital-nerve-and-forehead-neurotization-using-human-cadaveric-nerve-allograft
#17
Samer Bassilios Habre, James Bradford Depew, Robert D Wallace, Petros Konofaos
Neuroma pain can be severe, persistent, and treatment-resistant. Forehead and scalp anesthesia is troublesome for patients. Following an iatrogenic ablative injury to the right supraorbital nerve, with subsequent painful neuroma formation, a human cadaveric nerve allograft (AxoGen, Alachua, FL) was used to restore sensation of the right forehead and treat pain. At 1-year follow-up, the patient was pain-free, and protective sensation to the right forehead was recovered with comparable static and dynamic 2-point discrimination between the injured (20 mm, 12 mm respectively) and the normal side (15 mm, 10 mm respectively)...
March 8, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29505853/use-of-motor-evoked-potentials-during-lateral-lumbar-interbody-fusion-reduces-postoperative-deficits
#18
Michael R Riley, Adam T Doan, Richard W Vogel, Alexander O Aguirre, Kayla S Pieri, Edward H Scheid
Background Context Intraoperative neurophysiological monitoring (IONM) has gained rather wide-spread acceptance as a method to mitigate risk to the lumbar plexus during Lateral Lumbar Interbody Fusion (LLIF) surgery. The most common approach to IONM involves using only electromyography (EMG) monitoring, and the rate of postoperative deficit remains unacceptably high. Other test modalities, such as transcranial electric motor-evoked potentials (tcMEPs) and somatosensory-evoked potentials (SSEPs), may be more suitable for monitoring neural integrity but they have not been widely adopted during LLIF...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29492415/evaluation-of-infraorbital-canal-in-cone-beam-computed-tomography-of-maxillary-sinus
#19
Abdolaziz Haghnegahdar, Leila Khojastepour, Atefe Naderi
Statement of the Problem: Ignoring anatomic variations may lead to iatrogenic injuries by surgeons. Purpose: The aim of this study was to examine the relationship between the course of infraorbital canal and maxillary sinus using cone beam computed tomography scans (CBCT). Materials and Method: One hundred and ninety two CBCT scans were reviewed for 384 infraorbital canals. The anatomic variants of infraorbital canals were classified into three types based on the protrusion degree of the infraorbital nerve from the maxillary roof into the sinus...
March 2018: Journal of Dentistry
https://www.readbyqxmd.com/read/29484630/co-innervation-of-triceps-brachii-muscle-with-variant-branch-of-ulnar-nerve
#20
Sedat Develi
AIM: The aim of this study was to evaluate the existence of nerve innervation of the triceps brachii muscle via ulnar nerve and its clinical importance in terms of nerve transfer or susceptibility to iatrogenic injuries during surgical procedures. MATERIAL AND METHODS: 35 skeletally mature upper extremities of adult cadavers were included in the present study. Ulnar nerve was revealed from medial cord to the distal of cubital fossa. Existence of the branches of the ulnar nerve and communicant branch of the radial nerve was examined in the brachium...
February 7, 2018: Turkish Neurosurgery
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