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Delayed ulnar nerve palsy after open reduction and internal fixation of medial epicondylar fractures

Raymond E Anakwe1, Adam C Watts, Jane E McEachan

  • 1The Hand and Upper Limb Service, Department of Trauma and Orthopaedic Surgery, Queen Margaret Hospital, Dunfermline, Fife, UK. raymundus@doctors.org.uk

Journal of Pediatric Orthopedics. Part B
|January 23, 2010
PubMed

Insights

Delayed ulnar nerve palsies can occur after medial epicondyle fracture surgery in children. Complete surgical decompression is crucial to prevent nerve compression and ensure optimal outcomes.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Neurology

Background:

  • Medial epicondyle fractures are common in children.
  • Management of the ulnar nerve during operative fixation is debated.
  • Ulnar nerve complications can arise after surgical intervention.

Observation:

  • Two pediatric cases presented with delayed ulnar nerve palsies post-operative fixation.
  • The ulnar nerve is susceptible to compression distal to the elbow.
  • Incomplete surgical decompression was a potential factor.

Findings:

  • Delayed ulnar nerve palsy is a recognized complication.
  • Thorough surgical decompression is essential for preventing nerve injury.
  • Careful surgical technique is paramount in managing these fractures.

Implications:

  • Highlights the importance of vigilant ulnar nerve monitoring post-operatively.
  • Suggests a need for standardized surgical protocols for medial epicondyle fractures.
  • Informs orthopedic surgeons about potential delayed complications and their management.

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