How can patient positioning cause nerve injury and how can it be prevented?

• A. Prolonged pressure or awkward angles can injure nerves; use proper padding, alignment, and periodic checking of position.
• B. Nerve injuries only occur during surgery; posture doesn't matter.
• C. Only patients influence nerve injury.
• D. Nerve injuries cannot be prevented.

Answer: (B)

Nerve injury from patient positioning happens when nerves are compressed or stretched for an extended period during a procedure. When a nerve is pressed against a hard surface or held in an awkward angle, blood flow to the nerve can be reduced and signaling can be disrupted, leading to numbness, weakness, or longer-term deficits. Certain nerves are more vulnerable based on where the body rests and how it is supported. For example, the brachial plexus near the shoulder can be stressed if the arm is placed in excessive abduction or external rotation, the ulnar nerve at the elbow can be injured by prolonged elbow flexion or inadequate padding, and the common peroneal nerve behind the knee or at the fibular head can suffer from leg positions that exert pressure or twist the limb. Prevention centers on distributing pressure and maintaining neutral, comfortable alignment throughout the procedure: use padding and supports on bony prominences, keep joints in a natural position with minimal extremes, reassess and adjust the patient's position during long cases, and secure lines and devices so they do not shift the limb. Being mindful of these principles helps reduce the risk of nerve injury and supports better postoperative function.