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Intra-articular entrapment of the median nerve after elbow dislocation in children
W E Floyd1, M C Gebhardt, J B Emans
1Department of Orthopaedic Surgery, Children's Hospital Medical Center, Harvard Medical School, Boston, Mass.
Insights
Intra-articular median nerve entrapment can occur after pediatric elbow dislocation reduction. Early surgical exploration and nerve release are crucial for optimal management of this condition.
Area of Science:
- Pediatric Orthopedics
- Pediatric Surgery
- Nerve Entrapment Syndromes
Background:
- Elbow dislocations are common in children.
- Median nerve entrapment is a potential complication following elbow dislocation reduction.
- Delayed diagnosis can lead to poorer outcomes.
Observation:
- Two pediatric cases of intra-articular median nerve entrapment post-elbow dislocation reduction are presented.
- Clinical signs include proximal median nerve deficit and limited passive elbow motion.
- Associated medial epicondyle avulsion may be present.
Findings:
- Diagnosis of median nerve entrapment is frequently delayed in pediatric patients.
- Specific clinical indicators can suggest nerve entrapment after reduction.
- Early surgical intervention is recommended.
Implications:
- Prompt recognition of median nerve entrapment is vital for pediatric elbow trauma.
- Surgical exploration and nerve release offer optimal management.
- Awareness of these signs can prevent long-term nerve damage.
Abstract:
Two cases of intra-articular median nerve entrapment after reduction of elbow dislocations in children are described. The diagnosis of median nerve entrapment is often delayed. A proximal median nerve deficit, limited passive elbow motion, and an associated medial epicondyle avulsion after reduction of a child's posterior elbow dislocation should alert the surgeon to the possibility of nerve entrapment. Optimal management of this problem consists of early surgical exploration and nerve release.