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Published on: August 14, 2018
Neurovascular complications after supracondylar humerus fractures in children
Maximilian Leiblein1, Thomas Lustenberger1, Anne-Kathrin Schulz2
1Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Insights
Pediatric supracondylar humerus fractures treated with K-wires can cause neurovascular complications. Prompt open revision is crucial for managing these severe injuries, ensuring full recovery.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Pediatric Orthopedics
Background:
- Supracondylar humerus fractures are frequent in children.
- Closed reduction and percutaneous pinning with K-wires is a common surgical approach.
- Neurovascular complications, particularly brachial artery and median nerve injuries, are known risks.
Background:
Supracondylar fractures of the humerus are a common injury in pediatric traumatology. The most common operative therapy is closed reduction and percutaneous pinning using K-wires. Common complications associated with this entity are neurovascular lesions, especially of the brachial artery and the median nerve.
Methods:
We report two cases of patients treated in our trauma-center with supracondylar fracture of the humerus (AO IV°) and neurovascular complications.
Results:
Both patients underwent open revision and recovered completely in their further course.
Conclusion:
We recommend detailed neurovascular examination initially and after reposition of the fracture. The threshold for open reduction in cases of irreducible fractures should be low. In the presence of neurovascular impairment an open revision is mandatory, even months after the initial Trauma.Level of evidence: Level V (case report).
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Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...

