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[Treatment-related damage to the radial nerve in paediatric traumatology]
1Unfallchirurgie, Asklepios Klinik Lich, Deutschland.
Insights
Iatrogenic radial nerve damage can occur during pediatric upper extremity fracture treatment, with most cases involving sensory deficits. Cautious management is recommended, as spontaneous recovery is common, especially for sensory impairments.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Neurology
Context:
- Iatrogenic ulnar nerve damage is a known complication in treating pediatric supracondylar humeral fractures.
- Radial nerve damage can also occur during the treatment of various pediatric upper extremity fractures.
- Limited differentiated investigations exist regarding the incidence of iatrogenic radial nerve injuries in children.
Purpose:
- To present a prospective case collection of iatrogenic radial nerve damage in children.
- To describe personal experiences with the occurrence and management of these nerve injuries during growth.
- To analyze the incidence and characteristics of iatrogenic radial nerve injuries in pediatric fracture treatment.
Summary:
- This study prospectively collected cases of iatrogenic radial nerve damage during pediatric fracture treatment.
- Injuries occurred in primary care (9/20), during metal removal (9/20), and corrective surgery (2/20).
- Most cases involved forearm shaft fractures (50%), distal metaphysis radius fractures (39%), or radial neck fractures (11%). Sensory branches were most frequently affected (80%).
Impact:
- Highlights the incidence and patterns of iatrogenic radial nerve injuries in pediatric orthopedic practice.
- Emphasizes the need for cautious and restrained treatment approaches for nerve damage.
- Suggests that spontaneous remission is common, particularly for isolated sensory deficits, guiding clinical management decisions.
Background:
Iatrogenic damage of the N. ulnaris is a known complication of treatment of supracondylar humeral fractures in children. But damage to the N. radialis can also occur in the treatment of many typical fractures of the upper extremity during growth. There are no differentiated investigations on their incidence.
Patients And Methods:
This paper presents a prospective case collection and describes the personal experience with the occurrence and treatment of iatrogenic damage to the radial nerve during growth.
Results:
In all 9 out of 20 cases occurred in the primary care setting, a further 9 under the metal removal and 2 on the occasion of corrective surgery. 50 % occurred after treatment of forearm shaft fractures, 39 % after distal-metaphyseal radius fractures, 11 % after radial neck fractures. In 80 % of the cases the sensory terminal branch was affected, in another 15 % the motor branch and in 5 % the main trunk of the nerve.
Conclusions:
The treatment of iatrogenic nerve damage should be cautious and restrained, spontaneous remissions, especially of pure sensory deficits, are common.
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