Radial nerve entrapment after fracture of the supracondylar humerus: a rare case of a 6-year-old.

IF 1.1 4区 医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2022-09-01 DOI:10.5152/j.aott.2022.22062
Cheungsoo Ha, Soo-Hong Han, Ju Sung Lee, In-Tae Hong
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Abstract

Supracondylar fracture of the humerus is one of the most common fractures seen in children, and posteromedial displacement of the distal fragment in extension-type supracondylar humerus fractures can cause injury to the radial nerve. A 6-year old girl who presented with symptoms of radial nerve injury after a supracondylar fracture of the right humerus with complete posteromedial displacement of the distal fragment (Gartland type III) underwent surgery where closed reduction and percutaneous pinning was performed. The patient was routinely followed up and at 6 months postoperatively no neurological improvement was seen. Exploratory surgery revealed complete discontinuation of the radial nerve at the fracture site and entrapment of the nerve stumps in healed bone callus. A gap of 2 cm was observed between nerve stumps, and sural nerve cable grafting was performed with good results. If neurological symptoms do not improve over time, appropriate differential diagnosis and, if necessary, exploratory surgery should be considered. Despite limited reports and their conflicting outcomes, sural nerve cable grafting could be a useful option to bridge the gap of discontinued nerve injury. Level of Evidence: Level IV, Case Report.

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肱骨髁上骨折后桡神经卡压:一例罕见的6岁病例。
肱骨髁上骨折是儿童最常见的骨折之一,伸展型肱骨髁上骨折的远端碎片内侧后移位可引起桡神经损伤。一名6岁女孩在右肱骨髁上骨折后出现桡神经损伤症状,远端碎片完全后内侧移位(Gartland III型),她接受了闭合复位和经皮钉住手术。术后6个月对患者进行常规随访,未见神经系统改善。探查性手术显示桡骨神经在骨折部位完全断连,神经残端被困在愈合的骨痂中。残端神经间隙2 cm,行腓肠神经索移植,效果良好。如果神经症状没有随着时间的推移而改善,应考虑适当的鉴别诊断,如有必要,应考虑探查性手术。尽管报道有限,结果相互矛盾,腓肠神经索移植可能是一个有用的选择,以弥补中断性神经损伤的差距。证据等级:四级,病例报告。
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来源期刊
CiteScore
2.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
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