Nerve injuries in supracondylar fractures of the humerus in children (original) (raw)
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European review for medical and pharmacological sciences
Supracondylar humerus fractures are very common types of elbow fractures in children between the ages of three and ten years. Totally displaced supracondylar humerus fractures can be associated with neurovascular injuries, and treatment can be complicated by iatrogenic neurovascular injury, compartment syndrome, malunion, and elbow stiffness. The aim of this study was to describe the clinical outcome of nerve injuries associated with supracondylar humerus fractures in children observed over a period of seven years. Children with displaced supracondylar humerus fracture who were treated with closed reduction and percutaneous cross K-wire fixation were reviewed retrospectively at the Medical School Hospital of Yuzuncu Yil University from May 2004 to October 2012. There were 91 patients available for follow-up. Nerve injury was observed in 11 (12.1%) of 91 patients with supracondylar humerus fractures. In 10 (90.1%) of these 11 cases, nerve functions recovered completely (excellent out...
Annals of King Edward Medical University, 2015
Objective: The objective of this study was to com-pare the incidence of iatrogenic ulnar nerve injuries in two different techniques of cross Kirschner wire configuration for the fixation of paediatric supracon-dylar fractures of humerus. Methodology: Forty patients attending Accident and Emergency Department of The Children's Hospital and Institute of Child Health, Lahore, with supracon-dylar fracture of humerus were studied from September 2014 to March 2015 to compare the incidence of iatrogenic ulnar nerve injuries in two techniques of cross Kirschner wire configuration for the fixation of supracondylar fractures of humerus. These patients were divided in group A and group B. Each group consisted of 20 patients. The fracture of patients in group A was fixed with two lateral cross Kirschner wires configuration and fracture of patients in group B was fixed with mediolateral cross Kirschner wires con-figuration. All the operations were performed by same team of Paediatric ort...
Median Nerve Entrapment after Supracondylar Humeral Fracture in a Young Child
Case Reports in Orthopedics, 2019
Median nerve entrapment after supracondylar humeral fracture in children is rare. We report a case of Gartland type III supracondylar humeral fracture complicated by an entrapment of the median nerve following closed reduction and percutaneous pinning in a 5-year-old child. The diagnosis of entrapment was made 14 months post injury following progressive motor and sensory palsy. Resection and end-to-end suture were performed, leading to complete sensory and motor recovery eight months later. This nerve complication is often unnoticed and should be suspected systematically before and after reduction of all displaced supracondylar humeral fracture in children. The indication of resection-suture or nerve graft depends on the entrapment and the delay of the palsy.
Pomeranian Journal of Life Sciences
Two cases of paediatric radial and ulnar nerve injuries occurring at operative treatment of distal humeral epiphyseal fractures. In one case, the nerve laceration was associated with a defect, requiring reconstruction by nerve grafting. In a 2nd case, the nerve was compressed and partially damaged by implanting, followed by entrapment in the scar; release of the nerve from the scar resulted in recovery of its function. The importance of being familiar with the nerves’ course at the distal end of the humerus, as well as proper and prompt reaction to symptoms of nerve dysfunction occurring immediately after the operation was emphasised.
Early surgical exploration of radial nerve injury associated with fracture shaft humerus
Microsurgery, 2008
The series included 36 patients, predominantly male, mean age 30.3 years. The most common cause of injury was motor car accident in 20 patients. Postreduction radial nerve injury occurred in nine cases. Open fracture humerus with radial nerve injury in seven cases. The fractures were situated in the middle or distal third of the humeral shaft. Most were transverse fractures. Twelve patients had surgery on the day of injury and the other 24 at a mean of 8 days later (3-14). Narrow dynamic compression plate was generally used for fixation. Exploration of the radial nerve demonstrated compression at the lateral intermuscular septum in 19 cases, entrapment in the fracture site in nine cases, and loss of its continuity in eight cases. Neurolysis was required in 20 cases, epineurorrhaphy in nine cases, interfascicular nerve grafts in five, and first-intention tendon transfer in two. Results of nerve surgery were assessed with the MRC (Medical Research Council) at a mean follow-up of 8.2 years. Outcome was rated good to excellent in 28 patients, fair in 1, and poor (failure) in 3. Firstintention tendon transfers were performed in 2 patients and 2 patients were lost to follow-up. Mean delay to recovery was 7 months after neurolysis and nerve repair and 15 months after nerve grafts. The fracture was united in all cases. The mean time of union was 5 months. V
The epidemiology of forearm nerve injuries--a retrospective study
Acta clinica Croatica, 2015
The aim of this study was to investigate the mechanisms and etiologic factors of forearm nerve injuries. This retrospective survey included all patients treated surgically in Clinical Department of Neurosurgery, Clinical Center of Serbia, from January 1, 2000 to December 31, 2010. All relevant data were collected from medical records. Statistical procedures were done using the PASW 18 statistical package. Our study included 104 patients that underwent surgery after forearm nerve injury. The majority of admitted patients were male (n = 84; 80.8%) and only 20 (19.2%) were female. Ulnar nerve injury predominated with 70 cases, followed by median nerve with 54 (51.9%) cases and radial nerve with only 5 cases. Transection was the dominant mechanism of injury and it occurred in 84.6% of cases. Injury by a sharp object was the most frequent etiologic factor and it occurred in 62 (59.6%) patients, while traffic accident and gunshot injuries were the least common etiologic factor of forearm ...
Percutaneous K-wiring for Gartland type III supracondylar humerus fractures in children
Saudi medical journal, 2007
To assess the ability of closed reduction and percutaneous K-wire fixation, to obtain and maintain an adequate reduction, and thereby achieve satisfactory end results. A prospective study conducted on 60 children over 28 months at Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India, from March 2003 to June 2005, in which Gartland type-III supracondylar fracture humerus were treated by closed reduction and percutaneous pinning, either from lateral side only or from medial side also, under image intensifier control. There was no problem in union. Patients were graded by Flynn's criteria with excellent results in 88.88%, good in 4.44%, and fair in 2.24%, and poor in 4.44% cases. Only one patient had developed cubitus varus deformity and one had Iatrogenic Ulnar nerve palsy from medial pin, which recovered subsequently. The Baumann's angle was well with in the normal range of 66-84 degrees [corrected] Percutaneous K-wire fixation is a safe and effective m...
Orthopedics, 2006
This study determines the incidence of superficial radial nerve injury after Kirchner wire insertion. An experienced orthopedic surgeon inserted the K-wires into the radii of 92 adult cadavers. Subsequent dissection of the area exposed the superficial radial nerve and any observed nerve injury was documented. It is clear from the results that nerve injury may still occur as a result of K-wire insertion; however, the current method of K-wire insertion still proves to be a reliable and safe procedure for fixation of distal radial fractures.
Iatrogenic Peripheral Nerve Injuries-Surgical Treatment and Outcome: 10 Years' Experience
World neurosurgery, 2017
Iatrogenic nerve injuries are nerve injuries caused by medical interventions or inflicted accidentally by a treating physician. We describe and analyze iatrogenic nerve injuries in a total of 122 consecutive patients who received surgical treatment at our Institution during a period of 10 years, from January 1, 2003, to December 31, 2013. The final outcome evaluation was performed 2 years after surgical treatment. The most common causes of iatrogenic nerve injuries among patients in the study were the operations of bone fractures (23.9%), lymph node biopsy (19.7%), and carpal tunnel release (18%). The most affected nerves were median nerve (21.3%), accessory nerve (18%), radial nerve (15.6%), and peroneal nerve (11.5%). In 74 (60.7%) patients, surgery was performed 6 months after the injury, and in 48 (39.3%) surgery was performed within 6 months after the injury. In 80 (65.6%) patients, we found lesion in discontinuity, and in 42 (34.4%) patients lesion in continuity. The distribut...