Median Nerve Reconstruction After Entrapment in the Elbow

Abstract

Median nerve entrapment in the elbow is a known but rare complication of pediatric elbow dislocations. It is classified on the anatomical basis of entrapment. Due to a variety of factors, it is often diagnosed late. Because of this, substantial injury occurs to the nerve, requiring some form of restorative surgery in addition to release from the joint. Such nerve injury has been treated in a variety of ways including neurolysis, end-to-end anastomosis and nerve grafting. To date, there has been no conclusive evidence in the literature that one method should be preferred over another. A case of median nerve entrapment that was treated with sural nerve grafting is presented. In a review of the literature, previous treatment of such cases is discussed and compared.

Entrapment of median nerve after elbow fracture dislocations: expected surgical time frame based on cadaver study

“…Delay in the diagnosis of median nerve entrapment is frequently mentioned in case series reported in the literature [5,[11][12][13]. There are several reasons for this situation.…”

Closed Median Nerve Rupture from Elbow Trauma

“…Previous reports of median nerve injury from elbow dislocation describe injuries in which the median nerve remains in continuity and functional recovery is spontaneous [8,9]. In this manuscript, we report a case of a complete, closed, median nerve rupture, requiring repair after elbow dislocation.…”

“…Though relatively uncommon, median nerve injury following bony trauma of the upper extremity has been described in the literature following humeral fracture [4], forearm fracture [5], and combined dislocation of the shoulder and elbow [6]. Previous reports of median nerve injury from elbow dislocation describe injuries in which the median nerve remains in continuity and functional recovery is spontaneous [8, 9]. In this manuscript, we report a case of a complete, closed, median nerve rupture, requiring repair after elbow dislocation.…”