Critical displacement of neural injuries in supracondylar humeral fractures in children.
To investigate a relation between the degree of initial fracture displacement and nerve complication, 53 consecutive acute extension-type supracondylar humeral fractures in children during 10 years were analyzed. From the initial roentgenographs, the direction and degree of displacement of each fracture were plotted on the coronal two-dimensional coordinates at the fracture site. The degree of displacement was represented by a diameter of the humeral shaft. Of 53 fractures, 42 were displaced. Six patients had nerve injuries, representing an 11.3% incidence of neurologic complication. Their displacements were >90% of the diameter of the shaft. Predictive negative and positive displacements of the median nerve were <90% of the diameter and >150% of that in posterolaterally displaced fractures, respectively. Those of radial nerve were <130% and >190% in posteromedially displaced fractures, respectively.
Kiyoshige
Y
Y
Department of Orthopaedic Surgery, Saiseikai Yamagata Hospital, Japan. kyo@mbf.sphere.ne.jp
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D015994:Incidence; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000150:complications* / Q000175:diagnosis; D008297:Male; D020423:Median Neuropathy / Q000453:epidemiology / Q000209:etiology*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D000092464:Elbow Injuries