J Korean Fract Soc.
2002 Oct;15(4):595-600.
Neurologic Complications of Elbow Fractures in Children
- Affiliations
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- 1Department of Orthopedic Surgery, Inje University, Ilsan Paik Hospital, Ilsan Kyounggi, Korea. SKCHOO@ilsanpaik.ac.kr
Abstract
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PURPOSE: We analyzed neurologic complications of the elbow fractures in children and evaluated clinical results of type of fractures, frequency of nerve injuries and displacement of fracture fragments and spontaneous recovery of each nerve injuries.
MATERIALS AND METHODS
We analyzed 17 child-patients (20cases) with nerve injuries who were treated conservatively and follewed up for at least 1 year since December 1999. and we analyzed type of fractures, differences between fracture type and nerve injuries, frequency of each nerve injuries and periods of spontaneous recovery of each nerves.
RESULTS
There were all 148 elbow fractures in children. Children with neurologic complications were 17(20 nerves) and 14 in supracondylar and 3 in medial epicondylar fractures. There were 6 in radial nerve, 8 in ulnar nerve, 3 in median nerve and 3 in anterior interosseous nerve. Both ulnar and median nerve injuries were 3 patients. They were recovered spontaneously and mean periods of recovery was 7.3 weeks, 6.5 weeks in radial nerves, 7.0 in median nerves, 7.6 in anterior interosseous nerves, 7.8 in ulnar nerves and radial nerve recovery was most fast than any others. One patient with ulnar nerve injury who was diagnosed medial epicondylar fracture recovered 2 weeks after excision of nonuioned fragment. Among 14 supracondylar fractures, there was 11 posteromedial displacement, 1 posterolateral and 2 posterior. Most of them was displaced posteromedially.
CONCLUSION
All nerve injuries happened in supracondylar and medial condylar fractures and almost recovered. Nerve injuries in the supracondylar fractures was displaced fractures than nondisplaced simple fractures and displacement of fracture fragment and nerve injuries was not agreed with previous published books or papers. We recommand that observation is the appropriate way to manage these nerve injuries in most cases than immediate operation for excision.
