MEDIAN NERVE INJURY IN CHILDREN AGED 2-11 YEARS PRESENTING WITH CLOSED SUPRACONDYLAR FRACTURE OF HUMERUS
Abstract
Background: The supra-condylar humeral fractures are commonest fractures at the elbow in children and represent a third of all limb fractures in children under the age of 7 years. These fractures are associated with neurological deficit and any of the three long nerves of upper arm can be involved in these fractures. This study was conducted to determine the frequency of median nerve injury in children aged 2-11 years presenting with closed supracondylar fracture of humerus. Methods: This descriptive cross-sectional study was conducted at the department of orthopaedics and trauma, Ayub Teaching Hospital Abbottabad from July 2016 to June 2018. One hundred and seventy-one patients with supracondylar fracture of humerus were enrolled. They were treated as per department protocols and the outcome in terms of neurological damage was noted for each study participant. Results: The frequency of neurological damage was 21.05% with median nerve affected most commonly (13.45%). A statistically strong association was found between damage to median nerve and type of fracture, arm involvement and sex of patients (p<0.05) while no statistically significant association with age was obtained. Conclusion: Neurological damage is a common complication of supracondylar humeral fractures with median nerve being the most commonly affected nerve in these fractures.Keywords: Median Nerve; Supracondylar Fracture; Humerus; Open Reduction; Motor DeficitReferences
Mulpuri K, Wilkins K. The treatment of displaced supracondylar humerus fractures: evidence–based guideline. J Pediatr Orthop 2012;32(Suppl 2):S143–52.
Tomaszewski R, Wozowicz A, Wysocka–Wojakiewicz P. Analysis of early neurovascular complications of pediatric supracondylar humerus fractures: A long–term observation. Biomed Res Int 2017;2017:2803790.
Vaidya SV. Supracondylar humerus fractures in children: Epidemiology and changing trends of presentation. Int J Paediatr Orthop 2015;1(1):3–5.
Barr LV. Paediatric supracondylar humeral fractures: Epidemiology, mechanisms and incidence during school holidays. J Child Orthop 2014;8(2):167–70.
Wheeless CR. Pediatric supracondylar fractures of the humerus. [Internet]. Wheeless’s text book of orthopaedics 2016 [cited 2018 Jun 23]. Available from: http://www.wheelessonline.com/ortho/pediatric_supracondylar_fractures_of_the_humerus
Behdad A, Behdad S, Hosseinpour M. Pediatric elbow fractures in a major trauma center in Iran. Arch Traum Res 2013;1(4):172–5.
Kumar V, Singh A. Fracture supracondylar humerus: A review. J Clin Diagn Res 2016;10(12):RE1–6.
Garg S, Weller A, Larson AN, Fletcher ND, Kwon M, Schiller J, et al. Clinical characteristics of severe supracondylar humerus fractures in children. J Pediatr Orthop 2014;4(1):34–9.
Fletcher ND, Schiller JR, Garg S, Weller A, Larson AN, Kwon M, et al. Increased severity of type III supracondylar humerus fractures in the preteen population. J Pediatr Orthop 2012;32(6):567–72.
Kwok IH, Silk ZM, Quick TJ, Sinisi M, MacQuillan A, Fox M. Nerve injuries associated with supracondylar fractures of the humerus in children: our experience in a specialist peripheral nerve injury unit. Bone Joint J 2016;98–B(6):851–6.
Shore BJ, Gillespie BT, Miller PE, Bae DS, Waters PM. Recovery of Motor Nerve Injuries Associated With Displaced, Extension–type Pediatric Supracondylar Humerus Fractures. J Pediatr Orthop 2017;1056.
Valencia M, Moraleda L, Díez–Sebastián J. Long–term Functional Results of Neurological Complications of Pediatric Humeral Supracondylar Fractures. J Pediatr Orthop 2015;35(6):606–10.
Anjum R, Sharma V, Jindal R, Singh TP, Rathee N. Epidemiologic pattern of paediatric supracondylar fractures of humerus in a teaching hospital of rural India: A prospective study of 263 cases. Chin J Traumatol 2017;20(3):158–60.
Gera SK, Tan M, Lim YG, Lim K. Displaced Supracondylar Humerus Fractures in Children - Are They All Identical? Malays Orthop J 2017;11(2):40–4.
Mitchelson AJ, Illingworth KD, Robinson BS, Elnimeiry KA, Wilson CJ, Markwell SJ, et al. Patient demographics and risk factors in pediatric distal humeral supracondylar fractures. Orthopedics 2013;36(6):e700–6.
Cooper C, Dennison EM, Leufkens HG, Bishop N, van Staa TP. Epidemiology of childhood fractures in Britain: a study using the general practice research database. J Bone Miner Res 2004;19(12):1976–81.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.