Spontaneous Full Recovery of High Radial Nerve Palsy Following Closed Reduction and Percutaneous Pinning of Gartland IV Supracondylar Fracture: A Case Report
Autor: | Iyad S. Albustami, Mutaz A Alrawashdeh, Zain Almomani, Mohammad Rusan, Ali A. Al-Omari, Omar Obeidat |
---|---|
Rok vydání: | 2021 |
Předmět: |
Male
Humeral Fractures medicine.medical_specialty medicine.medical_treatment Remission Spontaneous Elbow Physical examination Bone Nails 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Hematoma Elbow Joint medicine Humans Child Reduction (orthopedic surgery) Radial nerve Palsy medicine.diagnostic_test business.industry Articles General Medicine Gartland classification medicine.disease Fracture Fixation Intramedullary Surgery Percutaneous pinning medicine.anatomical_structure 030220 oncology & carcinogenesis Radial Nerve Radial Neuropathy business |
Zdroj: | The American Journal of Case Reports |
ISSN: | 1941-5923 |
Popis: | Patient: Male, 8-year-old Final Diagnosis: Supracondylar fracture with radial nerve neuropraxia Symptoms: Wrist and finger drops Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Unusual clinical course Background: Supracondylar fracture is one of the most common pediatric traumatic fractures. It is subclassified into 2 entities: the extension type, which is predominantly seen, and the flexion type. It can be further classified into 4 types according to the Gartland classification, which assesses the anatomical severity of the fracture depending on the lateral radiographs of the elbow and operative findings. The usual mechanism of injury is falling on outstretched hands. Case Report: This study presents a rare case of high radial nerve palsy seen in an 8-year-old previously healthy male patient after closed reduction and percutaneous pinning of a Gartland type IV supracondylar fracture using 2 lateral diverging pins and 1 medial crossing pin. Several attempts of forceful maneuvers were needed to anatomically reduce the fracture. X-rays and contrasted CT scan were done after the surgery, confirming proper placement of pins and intact vascularity. However, a CT scan revealed a large hematoma in the posterior compartment of the arm and subcutaneous edema with soft-tissue swelling at the left elbow. A conservative management plan was established with serial physical examination and follow-up for the next 3–6 months. Subsequently, the patient experienced dramatic improvement of nerve function over 6 weeks following the surgery, and complete recovery of radial nerve motor and sensory function was achieved 2 months after the operation. Conclusions: Most nerve injuries are a neuropraxic nerve injuries, which resolve spontaneously without intervention. Physicians usually reserve any surgical intervention in case of progressive worsening of neurological deficit or if no improvement occurs in 3–6 months. |
Databáze: | OpenAIRE |
Externí odkaz: |