LATROGENIC NERVE LESIONS AND THEIR TREATM ENT

Injuries to the central or peripheral nerves caused by medical interve ntion are called iatrogenic nerve lesions. The caudal relationship bet ween medical intervention and iatrogenic nerve injuries is frequently not very clear. Careful pre- and post-operative examination of the pat ient, however, will in most instances reveal a nerve lesion in a timel y manner. Iatrogenic nerve lesions in the clinical cases available to us were predominantly due to indirect influences, such as pressure, in sertion of a retractor or heat; we discovered that only in a few cases a nerve was partially or completely severed or damaged by the materia l used for osteosynthesis. The pre- and postoperative clinical neurolo gical and electrophysiological examinations of our patients were perfo rmed by a neurologist. Nerve-repair was achieved by neurolysis in 19 c ases; a primary or secondary suture was performed in three cases. A ne rve graft was used in five cases to regain continuity. Those patients (nearly 75 %) who underwent restitutive surgery within an six-month pe riod after iatrogenic injury in the primary operation were treated suc cessfully. These results suggest that timely treatment is decisive for good outcome.