title: Nerve injuries associated with supracondylar fractures of the humerus in children: our experience in a specialist peripheral nerve injury unit.
abstract: OBJECTIVE
  We aimed to identify the pattern of nerve injury associated with paediatric supracondylar fractures of the humerus.
  
  
  METHODS
  Over a 17 year period, between 1996 and 2012, 166 children were referred to our specialist peripheral nerve injury unit. From examination of the medical records and radiographs were recorded the nature of the fracture, associated vascular and neurological injury, treatment provided and clinical course.
  
  
  RESULTS
  Of the 166 patients (111 male, 55 female; mean age at time of injury was seven years (standard deviation 2.2)), 26 (15.7%) had neurological dysfunction in two or more nerves. The injury pattern in the 196 affected nerves showed that the most commonly affected nerve was the ulnar nerve (43.4%), followed by the median (36.7%) and radial (19.9%) nerves. A non-degenerative injury was seen in 27.5%, whilst 67.9% were degenerative in nature. Surgical exploration of the nerves was undertaken in 94 (56.6%) children. The mean follow-up time was 12.8 months and 156 (94%) patients had an excellent or good clinical outcome according to the grading of Birch, Bonney and Parry.
  
  
  CONCLUSIONS
  Following paediatric supracondylar fractures we recommend prompt referral to a specialist unit in the presence of complete nerve palsy, a positive Tinel's sign, neuropathic pain or vascular compromise, for consideration of nerve exploration.
  
  
  CONCLUSIONS
  When managed appropriately, nerve recovery and clinical outcomes for this paediatric population are extremely favourable. Cite this article: Bone Joint J 2016;98-B:851-6.
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: I H Y
authors.initials: IH
authors.lastname: Kwok
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Silk
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Quick
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: M
authors.initials: M
authors.lastname: Sinisi
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: A
authors.initials: A
authors.lastname: MacQuillan
authors.affiliation: The Royal National Orthopaedic Hospital , Brockley Hill, Stanmore, London HA7 4LP, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fox
mesh_terms: D001808:Blood Vessels / Q000293:injuries; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000628:therapy; D008131:London; D008297:Male; D009437:Neuralgia / Q000209:etiology / Q000628:therapy; D009460:Neurologic Examination; D010243:Paralysis / Q000209:etiology / Q000628:therapy; D020127:Recovery of Function
keywords: Children; Fracture; Nerve injury; Supracondylar; Trauma