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Postoperative injuries are MOST often reported for which of the following peripheral nerves?
A. Common peroneal X
B. Ulnar ✔
C. Radial X
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Postoperative peripheral nerve injury (PNI) results from multiple factors, and the exact mechanisms remain unclear. Symptoms can include tingling, pain, weakness, and paresthesias. PNI is thought to be caused by a combination of local insults related to stretching, compression, and ischemia in addition to systemic injury that can involve hypotension and inflammation.
A qualitative systematic review found that the overall incidence of PNI is less than 1%, with a higher incidence in cardiac, neurosurgical, and some orthopedic procedures (hip and shoulder arthroplasties). PNIs are most often reported for the ulnar and brachial plexus nerves. Ulnar PNIs may not be preventable, and are more frequently noted in males, patients with a low or high body mass index, and in patients experiencing long periods of bed rest. Lower extremity PNIs (eg, to the common peroneal or sciatic nerves) are less common overall but are associated with surgeries in the lithotomy position. Postoperative radial nerve injuries are not commonly reported.
A 2018 practice advisory from the American Society of Anesthesiologists recommended careful evaluation of a patient’s preoperative history and physical assessment of neurologic symptoms. Positioning and padding strategies were addressed for different intraoperative surgical positions, with a recommendation for periodic assessment of positioning.
References
Date of last update: September 21, 2026
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