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Median nerve compression associated with displaced Salter-Harris type II distal radial epiphyseal fracture

P M Binfield1, A Sott-Miknas, C J Good

  • 1Department of Orthopaedics, Newham General Hospital, Plaistow, London, UK.

Injury
|March 18, 2000
PubMed

Insights

Immediate manipulation under anesthesia (MUA) effectively treated median nerve compression in children with Salter-Harris Type II distal radius fractures. This approach restored nerve function without long-term issues, avoiding carpal tunnel release.

Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Pediatric trauma

Background:

  • Salter-Harris Type II fractures are common in children.
  • Distal radius fractures can lead to median nerve compression.
  • Prompt management is crucial for pediatric orthopedic injuries.

Observation:

  • Three children presented with displaced distal radial epiphysis fractures (Salter-Harris Type II).
  • All cases exhibited rapidly developing median nerve compression.
  • Manipulation under anesthesia (MUA) was performed immediately.

Findings:

  • Median nerve function was rapidly restored post-MUA in all patients.
  • No late neurological sequelae were observed.
  • Immediate MUA without carpal tunnel release proved effective.

Implications:

  • Immediate MUA is a viable initial treatment for this specific pediatric fracture with nerve compression.
  • Carpal tunnel release may not be necessary in the acute setting.
  • Consideration for late median nerve exploration exists if deficits persist post-MUA.

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