Missed and iatrogenic nerve lesions are not encountered very often. Nevertheless, they represent an increasingly important subject because of their implications for the patient and the physician and ...their legal aspects. We present an overview of the patients with missed or iatrogenic nerve lesion treated at the Division for Plastic and Reconstructive Surgery of the Inselspital in Berne from 1980 to 1989. After a look at the legal aspects a few typical lesions and their treatments are illustrated. The diagnosis of a missed or iatrogenic nerve lesion differs in no way from that in other nerve lesions. Therefore, we favor an early surgical revision in all cases where the possibility of a transsected nerve must be suspected postoperatively.
We are often confronted with heavy destructions of the lower extremities, where there is no possibility to conserve the limb, because of the general or/and local conditions. In this situation it's ...wise to preserve vital rest structures that can be used for primary or secondary reconstructions of the injured limb. There are different possibilities, some of them are presented in the cases described in this article.
The transposition of the gracilis muscle is shown as a reliable modality of treatment in chronic soft tissue problems and fistulas of the anogenital region. A short summary of the specific anatomy is ...given. The clinical application is illustrated with 2 case reports.
