Çocuk suprakondiler humerus kırığında çoklu sinir zedelenmesi [Multiple neural injuries in a pediatric supracondylar humerus fracture]
Abstract
Neurological problems following paediatric elbow fracture is a clinically challenging problem. The main causes of neurological injury are traction injuries, impingement or direct trauma related with bony fragments and iatrogenic injuries. Anterior interosseous nerve is most commonly injured nerve in cases of extension fractures. At flexion type fractures ulnar nerve is the major traumatised nerve by iatrogenic manuplation. Multiple neural injuries related with these types of fractures are extremely rare. Neural injuries of paediatric cases have tendency to recover easily. In cases of persisting functional impairment surgical intervention may be needed. Herein a pediatric case with both medial and ulnar nerve injuries following elbow fracture was presented
References
- İnan M, Yücel B. Çocuklarda humerus suprakondiler bölge kırıkları. Totbid Der 2008;7(3):104-11.
- Eren A, Özkut AT, Altıntaş F, Güven M. Çocuklarda sup- rakondiler humerus tip III kırıkların tedavisinde late- ral ve medial girişimler ile cerrahi tedavi sonuçlarının fonksiyonel ve kozmetik açıdan karşılaştırılması. Acta Orthop Traumatol Turc 2005;39(3):199-204.
- Omid R, Choi PD, Skaggs DL. Supracondylar hu- meral fractures in children. J Bone Joint Surg Am 2008;90(5):1121-32.
- Ramachandran M, Birch R, Eastwood DM. Clinical out- come of nerve injuries associated with supracondylar fractures of the humerus in children: the experience of a specialist referral centre. J Bone Joint Surg Br 2006;88(1):90-4.
- Brown IC, Zinar DM. Traumatic and iatrogenic neu- rological complications after supracondylar humerus fractures in children. J Pediatr Orthop 1995;15(4):440- 3.
- Babal JC, Mehlman CT, Klein G. Nerve injuries associ- ated with pediatric supracondylar humeral fractures: a meta-analysis. J Pediatr Orthop 2010;30(3):253-63.
- Wilkins K. Supracondylar Fractures of the Distal Hu- merus. In: Beaty, James H.; Kasser, James R., edi- tors. Rockwood & Wilkins’ Fractures in Children. Vol. 1, 6th ed. Philadelphia: Lippincott; 2006, p. 543-89.
- Gürbüz H, Birtane M, Yalçin O. Evaluation of the late neurologic deficits accompanied by hypertrophic scars and keloids in children with elbow fractures. J Pediatr Orthop 2001;21(5):577-9.
- Green DW, Widmann RF, Frank JS, Gardner MJ. Low incidence of ulnar nerve injury with crossed pin placement for pediatric supracondylar humerus frac- tures using a mini-open technique. J Orthop Trauma 2005;19(3):158-63.
- Karakurt L, Ozdemir H, Yilmaz E, Inci M, Belhan O, Serin E. Morphology and dynamics of the ulnar nerve in the cubital tunnel after percutaneous cross- pinning of supracondylar fractures in children’s el- bows: an ultrasonographic study. J Pediatr Orthop B 2005;14(3):189-93.
Çocuk suprakondiler humerus kırığında çoklu sinir zedelenmesi [Multiple neural injuries in a pediatric supracondylar humerus fracture]
Abstract
Çocuk dirsek kırıkları sonrası nörolojik hasar klinik olarak ciddi bir problemdir. Sinir yaralanması primer olarak aşırı gerilme, sıkışma ve kırık fragmanın doğrudan hasarına bağlı veya iyatrojenik olabilir. Ekstansiyon tipi kırıklarda en sık anterior interoseöz sinir yaralanırken, fleksiyon tipinde ve iyatrojenik olarak en sık hasar ulnar sinirde gözlenir. Bu kırıklara eşlik eden birden fazla sinir arazı ise çok nadirdir. Pediatrik vakalarda sinir hasarı genel itibariyle iyileşme eğilimindedir. Altı ay geçtiği halde fonksiyonlarda iyileşme olmayan vakalarda cerrahi seçenekler ön plana çıkmaktadır. Bu yazıda dirsek kırığı sonrası median ve ulnar sinir zedelenmesi olan bir çocuk olgu sunuldu.
References
- İnan M, Yücel B. Çocuklarda humerus suprakondiler bölge kırıkları. Totbid Der 2008;7(3):104-11.
- Eren A, Özkut AT, Altıntaş F, Güven M. Çocuklarda sup- rakondiler humerus tip III kırıkların tedavisinde late- ral ve medial girişimler ile cerrahi tedavi sonuçlarının fonksiyonel ve kozmetik açıdan karşılaştırılması. Acta Orthop Traumatol Turc 2005;39(3):199-204.
- Omid R, Choi PD, Skaggs DL. Supracondylar hu- meral fractures in children. J Bone Joint Surg Am 2008;90(5):1121-32.
- Ramachandran M, Birch R, Eastwood DM. Clinical out- come of nerve injuries associated with supracondylar fractures of the humerus in children: the experience of a specialist referral centre. J Bone Joint Surg Br 2006;88(1):90-4.
- Brown IC, Zinar DM. Traumatic and iatrogenic neu- rological complications after supracondylar humerus fractures in children. J Pediatr Orthop 1995;15(4):440- 3.
- Babal JC, Mehlman CT, Klein G. Nerve injuries associ- ated with pediatric supracondylar humeral fractures: a meta-analysis. J Pediatr Orthop 2010;30(3):253-63.
- Wilkins K. Supracondylar Fractures of the Distal Hu- merus. In: Beaty, James H.; Kasser, James R., edi- tors. Rockwood & Wilkins’ Fractures in Children. Vol. 1, 6th ed. Philadelphia: Lippincott; 2006, p. 543-89.
- Gürbüz H, Birtane M, Yalçin O. Evaluation of the late neurologic deficits accompanied by hypertrophic scars and keloids in children with elbow fractures. J Pediatr Orthop 2001;21(5):577-9.
- Green DW, Widmann RF, Frank JS, Gardner MJ. Low incidence of ulnar nerve injury with crossed pin placement for pediatric supracondylar humerus frac- tures using a mini-open technique. J Orthop Trauma 2005;19(3):158-63.
- Karakurt L, Ozdemir H, Yilmaz E, Inci M, Belhan O, Serin E. Morphology and dynamics of the ulnar nerve in the cubital tunnel after percutaneous cross- pinning of supracondylar fractures in children’s el- bows: an ultrasonographic study. J Pediatr Orthop B 2005;14(3):189-93.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | September 1, 2012 |
| Published in Issue | Year 2012 Volume: 3 Issue: 3 |