Surgical Management of Flexion Type Supracondylar Humeral Fracture With Ulnar Nerve Injury - A Report of a Rare Case

Vellingiri, Kishore; Suryanarayana, Meenakshi S Andra; Sambathkumar, Balasaranaya; Seenappa, Hariprasad

doi:10.7759/cureus.26433

Cited by 2 publications

(1 citation statement)

References 10 publications

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“…Kuoppala et al reported that seven patients with flexion-type SHFs showed increased carrying angles (CA): the mean CA was 50% greater in injured elbows (21°) than in uninjured elbows (14°) [ 9 ]. Moreover, case reports by Hara et al [ 10 ] and Vellingiri et al [ 11 ] on the surgical treatment of flexion-type SHFs demonstrated an increased CA in all three patients at the final follow-up. In our case, the patient showed an increase in the HEW angle by 14°, and radiographic images revealed the presence of subtle comminution of the lateral column.…”

Section: Discussionmentioning

confidence: 74%

Persistent Ulnar Nerve Palsy with Cubitus Valgus Deformity Following a Surgically Treated Flexion-type Supracondylar Humeral Fracture – A Case Report

Ito,

Kimura,

Suzuki

et al. 2023

JOCR

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Introduction: Supracondylar humeral fractures (SHFs) in children are mostly extension-type. SHFs have a high risk of cubitus varus deformity, while valgus deformity is rarely described. Nerve palsy can also occur during or after the injury, with most cases recovering spontaneously. Here, we present a rare case of cubitus valgus deformity after a flexion-type SHF with ulnar nerve (UN) palsy, which was successfully treated by corrective osteotomy and anterior transposition of the UN. Case Report: A 10-year-old girl had left-sided cubitus valgus deformity with persistent UN palsy 4 months after open reduction and internal fixation (ORIF) at another hospital. Half a year after the initial operation, corrective osteotomy of the distal humerus with neurolysis and subcutaneous anterior transposition of the UN were performed. She showed excellent recovery 14-month postoperatively and reported restored motor and sensory function with symmetrical elbow appearance. Conclusion: Surgeons usually observe the elbow angle carefully to avoid cubitus varus deformity. However, when treating a case of flexion-type SHFs, ORIF should be conducted to avoid cubitus valgus deformity, which could potentially cause UN traction as well as cosmetic dissatisfaction. Keywords: Elbow, humerus, supracondylar fracture, ulnar nerve, cubitus valgus.

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Section: Discussionmentioning

confidence: 74%

Persistent Ulnar Nerve Palsy with Cubitus Valgus Deformity Following a Surgically Treated Flexion-type Supracondylar Humeral Fracture – A Case Report

Ito,

Kimura,

Suzuki

et al. 2023

JOCR

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Minimally invasive techniques utilizing the “Joy Stick” method for managing irreducible flexion-type supracondylar fractures of the humerus in older children

Li,

Feng,

Chu

et al. 2024

J Orthop Surg Res

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Objective In this study, we investigated the efficacy of percutaneous poking reduction and Kirschner wire fixation in older children with irreducible supracondylar flexion-type fractures of the humerus. Methods This retrospective investigation included 27 children, comprising 15 males and 12 females, aged between 10 years and 3 months to 14 years and 11 months, all diagnosed with a flexion-type supracondylar fracture of the humerus within one week of trauma. All patients underwent surgery under general anesthesia. Following unsuccessful manual reduction, percutaneous poking reduction with Kirschner wires was performed under C-arm fluoroscopy to achieve fracture reduction. Following successful reduction, three 2.0 mm Kirschner wires were inserted in a cross pattern to secure the fracture ends. Postoperatively, the elbow joint was immobilized in a functional position with a plaster cast for four weeks. Results Follow-up in the outpatient department ranged from 9 to 36 months. Clinical functional assessment using Flynn’s criteria rated 24 cases as excellent, 2 as good, and 1 as fair, yielding an overall efficacy of 96.3%. No cases of fracture re-displacement, fracture fragment necrosis, or other complications such as nonunion, iatrogenic nerve injury, myositis ossificans, or long-term elbow joint dysfunction were observed during the postoperative follow-up. Conclusion The percutaneous poking reduction and Kirschner wire fixation technique is a simple and reliable procedure for treating irreducible flexion-type supracondylar fractures of the humerus in older children, with minimal trauma. This technique offers substantial stability for the fracture and results in excellent long-term recovery of joint function.

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Surgical Management of Flexion Type Supracondylar Humeral Fracture With Ulnar Nerve Injury - A Report of a Rare Case

Cited by 2 publications

References 10 publications

Persistent Ulnar Nerve Palsy with Cubitus Valgus Deformity Following a Surgically Treated Flexion-type Supracondylar Humeral Fracture – A Case Report

Persistent Ulnar Nerve Palsy with Cubitus Valgus Deformity Following a Surgically Treated Flexion-type Supracondylar Humeral Fracture – A Case Report

Minimally invasive techniques utilizing the “Joy Stick” method for managing irreducible flexion-type supracondylar fractures of the humerus in older children

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