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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 90-94.
doi: 10.1302/0301-620X.88B1.16869  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Clinical outcome of nerve injuries associated with supracondylar fractures of the humerus in children

THE EXPERIENCE OF A SPECIALIST REFERRAL CENTRE

M. Ramachandran, MB, FRCS(Orth), Specialist Orthopaedic Registrar1; R. Birch, MChir, FRCS, Professor, Consultant Orthopaedic Surgeon1; and D. M. Eastwood, MB, FRCS, Consultant Orthopaedic Surgeon1

1 The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should be sent to Miss D. M. Eastwood; e-mail: DMEastwood{at}btinternet.com

Between 1998 and 2002, 37 neuropathies in 32 patients with a displaced supracondylar fracture of the humerus who were referred to a nerve injury unit were identified. There were 19 boys and 13 girls with a mean age of 7.9 years (3.6 to 11.3). A retrospective review of these injuries was performed. The ulnar nerve was injured in 19, the median nerve in ten and the radial nerve in eight cases. Fourteen neuropathies were noted at the initial presentation and 23 were diagnosed after treatment of the fracture. After referral, exploration of the nerve was planned for 13 patients. Surgery was later cancelled in three because of clinical recovery. Six patients underwent neurolysis alone. Excision of neuroma and nerve grafting were performed in four. At follow-up, 26 patients had an excellent, five a good and one a fair outcome.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General