ULNAR NERVE PALSIES AFTER PERCUTANEOUS CROSS-PINNING OF SUPRACONDYLAR HUMERUS FRACTURES IN CHILDREN

Abstract

Introduction: In this study, we retrospectively evaluated the iatrojenic ulnar nerve palsies after percutaneous cross-pinning of the type III supracondylar humeral fractures in children.
Patients and methods: Between 1995 and 1999, 32 displaced supracondylar humeral fractures in children were treated with closed reduction and percutaneous cross-pinning. Four cases with normal preoperative neurologic examinations had postoperative ulnar nerve palsies. All patients are male with the age ranged between 3 and 11 years. Intrinsic function loss and sensory loss of small and ulnar half of the ring digits were the postoperative signs of ulnar nerve involvement. Three patients with electromyogram showed total axonal degeneration and one patient showed partial axonal degeneration. Because we did not find posteriorly seated medial pin and immediate progressive ulnar nerve palsy, exploration at the follow-up period was not performed. The cases were only observed by physical examination and EMG studies.
Results: Three patients had complete return of function at 2 to 3 months. One patient had complete motor recovery with minimal hypoestesia at the end of 1 year.
Conclusion: Ulnar nerve palsies occuring after percutanous cross-pinning of the supracondylar humeral fracture can usually resolve spontaneously.