[Nerve injuries due to fractures in childhood : Primarily and secondarily on the upper extremity].

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-04-01 Epub Date: 2024-03-05 DOI:10.1007/s00113-024-01423-3
Richarda Böttcher, Frank Dähne, Sebastian Böttcher, Ulrike Johl, Anja Tittel, Ulrike Schnick
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Abstract

The approach for nerve injuries in children in the context of fractures of the upper extremities is inconsistent in the literature. The underlying mostly retrospective studies do not usually consider the potential diagnostics. The frequency of nerve injuries with a clear need for reconstructive surgery is sometimes estimated so differently that precedent-setting errors in these studies must be assumed; however, as 10-20% of pediatric fractures near the elbow show primary or secondary nerve lesions, timely and appropriate further treatment is necessary. An overview concerning diagnostic tools with an explanation of potential results and an algorithm with a timeline for diagnostic and therapeutic management are presented. Good results after nerve lesions can only be achieved when timely diagnostics without delay and correct detection of axonal lesions which benefit from surgical treatment are carried out.

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[儿童骨折导致的神经损伤:主要和次要发生在上肢]。
文献中对儿童上肢骨折时神经损伤的处理方法并不一致。相关研究多为回顾性研究,通常不考虑潜在的诊断方法。对明显需要进行重建手术的神经损伤频率的估计有时差异很大,因此必须假定这些研究存在先例错误;然而,由于10%-20%的肘部附近小儿骨折会出现原发性或继发性神经损伤,因此有必要进行及时、适当的进一步治疗。本文概述了诊断工具,解释了潜在的结果,并提供了诊断和治疗管理的算法和时间表。神经损伤后只有及时进行诊断,并正确检测出轴索病变并进行手术治疗,才能取得良好的治疗效果。
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