[Ulnar nerve lesions after osteosynthesis of a supercondylar humerus fracture during childhood. Indications for revision].
Since 1948, closed reduction and osteosynthesis for supracondylar humeral fractures using two K-wires from the medial and lateral side has been performed on a regular basis. Although this procedure is used routinely, many authors have described paralysis of the ulnar nerve after blindly inserting the medial K-wire. Only very few publications describe the treatment options after iatrogenic paralysis of this nerve. The patients described showed progressive paralysis of the ulnar nerve after K-wire osteosynthesis. Intraoperatively, all patients showed scarring but intact continuity. After surgical revision and neurolysis, all four patients showed complete restitution after 1 year. If patients show progressive paralysis of the ulnar nerve early operative revision after 3 months should be performed.
Jester
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Klinik für Plastische, Hand- und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Plastische und Handchirurgie der Universität Heidelberg, BG-Unfallklinik Ludwigshafen, Ludwigshafen, Germany. andrea.jester@urz.uni-heidelberg.de
Flügel
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Germann
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Oestreich
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K
D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000601:surgery; D005260:Female; D005385:Fingers / Q000294:innervation; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D010292:Paresthesia / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012784:Shoulder Fractures / Q000601:surgery*; D014459:Ulnar Nerve / Q000293:injuries* / Q000601:surgery; D020424:Ulnar Neuropathies / Q000209:etiology / Q000601:surgery*