Iatrogenic or fracture-related nerve injuries in supracondylar humerus fracture: is treatment necessary for nerve injury?

BACKGROUND: Supracondylar humerus fractures are very common types of elbow fractures in children between the ages of three and ten years. Totally displaced supracondylar humerus fractures can be associated with neurovascular injuries, and treatment can be complicated by iatrogenic neurovascular injury, compartment syndrome, malunion, and elbow stiffness.

AIM: The aim of this study was to describe the clinical outcome of nerve injuries associated with supracondylar humerus fractures in children observed over a period of seven years.

PATIENTS AND METHODS: Children with displaced supracondylar humerus fracture who were treated with closed reduction and percutaneous cross K-wire fixation were reviewed retrospectively at the Medical School Hospital of Yuzuncu Yil University from May 2004 to October 2012.

RESULTS: There were 91 patients available for follow-up. Nerve injury was observed in 11 (12.1%) of 91 patients with supracondylar humerus fractures. In 10 (90.1%) of these 11 cases, nerve functions recovered completely (excellent outcome) and in one (9.9%) case partial recovery was seen (good outcome).

CONCLUSIONS: Iatrogenic or fracture-related nerve injury in a supracondylar humerus fracture is a benign condition which may be resolved spontaneously and observation appears to be a good and valuable method for treatment of this complication.