Injection-related iatrogenic peripheral nerve injuries: Surgical experience of 354 operated cases

Desai, Ketan; Warade, Anshu; Jha, Ashish; Pattankar, Sanjeev

doi:10.4103/0028-3886.250703

Cited by 21 publications

(12 citation statements)

References 2 publications

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“…The case described by Nischal et al was managed by debridement and reconstruction with a flap from the anterior thigh. 8 Our patient presented with necrosis and gangrene, for which intravenous antibiotics, analgesics, and surgical debridement with reconstruction were the mainstay of treatment.…”

Section: Discussionmentioning

confidence: 94%

Tissue Damage Caused by Diclofenac Intramuscular Injection: The Nicolau Syndrome

Anees

Hassan

Motiwala

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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Introduction Nicolau syndrome is an extremely rare complication following intramuscular administration of drugs leading to tissue damage and necrosis. Case Report In this case, the patient received the injection from an untrained quack surgeon (Jarrah) due to an improper intramuscular injection technique. A 45-year-old female complained of pain and blackish discoloration of the skin over the left buttock after receiving an intramuscular diclofenac injection.4 The patient was managed by administering intravenous antibiotics and analgesics, followed by surgical debridement. Flap reconstruction was done after granulation tissue formation. Conclusion Healthcare should be sought from appropriately trained and licensed professionals. Patients should be well educated on this. Pain, erythema, and discoloration should be recognized as red flags of the Nicolau syndrome so that it can be addressed promptly to avoid complications.

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Section: Discussionmentioning

confidence: 94%

Tissue Damage Caused by Diclofenac Intramuscular Injection: The Nicolau Syndrome

Anees

Hassan

Motiwala

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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“…On the contrary, external neurolysis is a very simple and relatively safe ancillary procedure that has proven benefits in a variety of peripheral neuropathies secondary to adhesions, as has been reported in the literature. 34 36 37 38 Although many peripheral nerve surgeons incorporate external neurolysis of the median nerve in their carpal tunnel decompression, a very limited body of clinical evidence exists to justify the same.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Long-Term Outcome in Open Carpal Tunnel Release Surgeries with and without External Neurolysis of Median Nerve, Using Boston Carpal Tunnel Questionnaire (BCTQ)–Hindi Version

Pattankar

Rohan

Warade

et al. 2021

JNRP

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Background The effectiveness of open carpal tunnel release (OCTR) in treating carpal tunnel syndrome (CTS) is well known. However, the role of ancillary external neurolysis of the median nerve is not well-documented. The Boston carpal tunnel questionnaire (BCTQ) is a commonly used disease-specific outcome instrument for CTS, which is validated across major languages of the world. No such validated Hindi version of BCTQ exists. Objectives To analyze and compare the long-term outcome in patients who underwent OCTR alone and OCTR with external neurolysis of the median nerve, using BCTQ–Hindi version, while checking its validity. Materials and Methods A retrospective, cross-sectional study was conducted at a tertiary care institute. The BCTQ was translated into Hindi language by a language expert. Eighty-four consecutive patients who underwent either unilateral/bilateral OCTR, with or without external neurolysis of the median nerve, between 2009 and 2019 were included in the study. Outcome analysis was done using BCTQ–Hindi version and patient satisfaction scoring. BCTQ–Hindi version was examined for statistical validity. Subgroup analysis of the outcome based on surgical technique (OCTR vs. OCTR with external neurolysis) used was carried out. Results Response rate was 80.9%. Total hands evaluated were 108. BCTQ–Hindi version showed statistical validity. Overall symptom severity score (SSS) and functional severity score (FSS) were 1.14 ± 0.4 and 1.12 ± 0.35, respectively. Subgroup analysis of outcome revealed statistically significant results in favor of OCTR with external neurolysis of the median nerve. Conclusions BCTQ–Hindi version is statistically validated. OCTR with external neurolysis of the median nerve is a promising avenue in surgical management of CTS. Further prospective studies are warranted.

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“…7 patients had an infectious spondylitis, 1 patient died of an uncontrolled infection and 2 patients had partial recovery of their neurological condition. Finally, Desai et al [107] published a review of 17 years where reflected the iatrogenic peripheral nerve injuries due to injections. They included "intramuscular injections, brachial nerves procedures, subclavian and jugular venous cannulation and routine intravenous injections".…”

Section: Incidence/frequency Of Adverse Effectsmentioning

confidence: 99%

“…Other incidents (less frequent) reported in the literature but not less important are cardiac tamponade [21,39,51,75,77], granulomas [23], fistulas [24,38], necrosis [25,42,85], infections [27,57,119], abscesses [27,45,61,71,74,76], pneumoretroperitoneum [32], hemorrhages [35], hemopericardium [37], haematomas [40,64,67,109,111,117], chilotorax [41], organ perforation [48,60], needle rupture [53,55,117], hemiplegia [54], hemothorax [56], peritonitis [66], cellulitis [72], hypokalemic paralysis [84], nerve injury [86,99,102,107,108,110,116], weakness …”

Section: Most Prevalent Adverse Effectsmentioning

confidence: 99%

Needling Therapies in the Outpatient Care: Adverse Effects

Llamas-Ramos¹,

Llamas-Ramos²

2022

Ultimate Guide to Outpatient Care

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The invasive techniques have been used for many years. There is a lot of literature on the advances that have been made, as well as the adverse effects or possible complications that have occurred during the performance of these treatments. Acupuncture and injections (saline, anesthetics, corticosteroids or botulinum toxin) have reported several cases of complications. Dry needling is also beginning to have several publications of this type. The objective of this chapter is to summarize the articles published in relation to adverse effects of needling therapies to promote a good practice and knowledge. Original articles in form of randomized controlled trials, case reports and reviews relating adverse effects and possible complications due to invasive/needling techniques: acupuncture, injections and dry needling have been included. 102 articles met the inclusion criteria between January 2000 and January 2020. The first limitation found in the literature was the huge variety of cases, therapists and incidents to generalize. As a conclusion we can stated the importance of a good knowledge of the anatomy and its variants, the correct application of these techniques and a continuous training of these therapists must be essential.

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Injection-related iatrogenic peripheral nerve injuries: Surgical experience of 354 operated cases

Cited by 21 publications

References 2 publications

Tissue Damage Caused by Diclofenac Intramuscular Injection: The Nicolau Syndrome

Tissue Damage Caused by Diclofenac Intramuscular Injection: The Nicolau Syndrome

Analysis of the Long-Term Outcome in Open Carpal Tunnel Release Surgeries with and without External Neurolysis of Median Nerve, Using Boston Carpal Tunnel Questionnaire (BCTQ)–Hindi Version

Needling Therapies in the Outpatient Care: Adverse Effects

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