title: [Nerve injuries after elbow luxation fractures in childhood : Indication and timing for surgical revision].
abstract: BACKGROUND
  Supracondylar humerus fractures are very common in pediatric populations. In cases of dislocated fractures, closed reduction and percutaneous K‑wire fixation is recommended. Initially, 10-16 % of the patients also present lesion of the ulnar nerve as well as median nerve palsy in 6.4% and radial nerve palsy in 2.6 % of cases, respectively.
  
  
  METHODS
  We present the case of a 10-year-old boy with a dislocation of the elbow and fracture of the medial epicondyle. After closed reduction and K‑wire fixation from medial, he presents a median nerve palsy. That a lesion of the ulnar nerve is also present is only noticed 3½ years posttraumatically. A surgical decompression and neurolysis of the ulnar and median nerve is performed and the postoperative grip and key strength presented.
  
  
  CONCLUSIONS
  With the help of the presented case we discuss the indication and the point of surgical revision. Clinical assessment and neurosonography are essential for an exact diagnosis.
authors.affiliation: Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, BG Unfallklinik Tübingen, Eberhard-Karls-Universität Tübingen, Tübingen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Wenger
authors.affiliation: Abteilung für Unfallchirurgie, Salzkammergut-Klinikum Bad Ischl, Bad Ischl, Österreich.
authors.forename: J
authors.initials: J
authors.lastname: Berger
authors.affiliation: Ordination für Plastische, Ästhetische und Rekonstruktive Chirurgie, Kalmanstraße 41, 1130, Wien, Österreich. piza@aon.at.
authors.forename: H
authors.initials: H
authors.lastname: Piza-Katzer
mesh_terms: D002648:Child; D000066491:Clinical Decision-Making / Q000379:methods; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D004551:Elbow Joint / Q000601:surgery*; D000072039:Fracture Dislocation / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D020423:Median Neuropathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D061665:Time-to-Treatment; D017769:Ulnar Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D057832:Watchful Waiting / Q000379:methods; D000092464:Elbow Injuries
keywords: Elbow dislocation; Medial epicondyle; Median nerve; Supracondylar humerus fracture; Ulnar nerve