Analysis of Early Neurovascular Complications of Pediatric Supracondylar Humerus Fractures: A Long-Term Observation

Abstract

Purpose. Analysis of early vascular and nerve complications of supracondylar humerus fractures in children. Material and Methods. 220 children hospitalized in the Pediatric Trauma-Orthopedic Department in the years 2004–2014. The group consisted of 143 males and 77 females. Results. Acute neurovascular complications occurred in 16.81% of patients with displaced supracondylar fracture (37 children). Nerve damage was found in 10% of patients with displaced fracture (22 children). The most injured nerve was median nerve; this complication occurred in 15 patients (68.18%). The total nerve function returned after average of 122 days (0–220 days after surgery). Symptoms of vascular injury occurred in 7.7% children with displaced fracture (17 children). Conclusions. (1) In children with supracondylar fracture the most often injured nerve is median nerve. (2) The incidence of vascular and nerve complications positively correlates with the progression of fracture according to Gartland classification.

Flexion-Type Supracondylar Humeral Fracture with Ulnar Nerve Injury in Children: Two Case Reports and Review of the Literature

“…Although extension-type fractures are associated more with brachial artery and anterior interosseous nerve injury, the flexion-type fractures, in contrast, are associated with ulnar nerve injury [3,13]. The ulnar nerve can be injured either 1) because it can become entrapped between the distal and the proximal fragment or 2) because the nerve can become stretched over the posterior spike of the proximal fragment or 3) from the placement of a K-wire on the medial side, near the cubital tunnel [4,14]. Most injuries are neurapraxia rather that axonotmesis or neurotmesis and usually resolve in less than 6 months, approximately 10 weeks.…”

Trombose venosa profunda após uma fratura supracondilar do úmero em uma criança – Uma complicação rara

“…As complicações precoces incluem danos às estruturas neurovasculares ou musculares e síndrome compartimental. 9 Lesões neurológicas, mais frequentemente na forma de neuropraxia, são comuns ($ 20%), e afetamo principalmente o nervo mediano e seu ramo interósseo anterior. 3,9 As lesões mais desastrosas são vasculares, pois, quando não tratadas, podem levar a déficits neurológicos, rigidez muscular, ou contraturas isquêmicas de Volkmann.…”

Median Nerve Entrapment after Supracondylar Humeral Fracture in a Young Child

“…Neurological complications in extension-type III SCHF in children represent 15% of cases [9], most of them involving damage of the median nerve and the AIN [1, 7, 10, 11]. Posterolateral displacement is generally incriminated [1].…”