Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children

A retrospective review of 162 displaced supracondylar fractures in children at Los Angeles County Harbor-UCLA Medical Center from 1975-1981 revealed 23 neural injuries. These injuries occurred in 19 patients whose ages ranged from 5-11 years of age. There were 12 radial, six ulnar, and five median neuropathies detected. Four of the ulnar nerve injuries and one radial nerve injury were iatrogenic, resulting from both percutaneous pinning and open reduction and internal fixation. All of the deficits resolved spontaneously within a range of 2-6 months. The average time to resolution for traumatic injuries was 2.3 months. Fifty-eight percent of these injuries were found to be associated with a Holmberg type III fracture pattern and 42% with a type IV supracondylar fracture.