Journal of Musculoskeletal Trauma

Neurologic Complications of Elbow Fractures in Children: Suk Kyu Choo, Gyu Won Park; J Korean Soc Fract 2002;15(4):595-600. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.595

Abstract PDF: PURPOSE
We analyzed neurologic complications of the elbow fractures in children and evaluated clinical results of type of fractures, frequency of nerve injuries and displacement of fracture fragments and spontaneous recovery of each nerve injuries.
MATERIALS AND METHODS
We analyzed 17 child-patients (20cases) with nerve injuries who were treated conservatively and follewed up for at least 1 year since December 1999. and we analyzed type of fractures, differences between fracture type and nerve injuries, frequency of each nerve injuries and periods of spontaneous recovery of each nerves.
RESULTS
There were all 148 elbow fractures in children. Children with neurologic complications were 17(20 nerves) and 14 in supracondylar and 3 in medial epicondylar fractures. There were 6 in radial nerve, 8 in ulnar nerve, 3 in median nerve and 3 in anterior interosseous nerve. Both ulnar and median nerve injuries were 3 patients. They were recovered spontaneously and mean periods of recovery was 7.3 weeks, 6.5 weeks in radial nerves, 7.0 in median nerves, 7.6 in anterior interosseous nerves, 7.8 in ulnar nerves and radial nerve recovery was most fast than any others. One patient with ulnar nerve injury who was diagnosed medial epicondylar fracture recovered 2 weeks after excision of nonuioned fragment. Among 14 supracondylar fractures, there was 11 posteromedial displacement, 1 posterolateral and 2 posterior. Most of them was displaced posteromedially.
CONCLUSION
All nerve injuries happened in supracondylar and medial condylar fractures and almost recovered. Nerve injuries in the supracondylar fractures was displaced fractures than nondisplaced simple fractures and displacement of fracture fragment and nerve injuries was not agreed with previous published books or papers. We recommand that observation is the appropriate way to manage these nerve injuries in most cases than immediate operation for excision.

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fracture and Dislocation of the Elbow Treated with Compass Elbow Hinge: Hyung Bin Park, Hae Ryong song; J Korean Soc Fract 1998;11(3):709-717. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.709

Abstract PDF: Post-traumatic elbow stiffness is a common and disastrous complication after acute elbow injury. prolonged immobilization universally leads to stiffness. Stable fixation and controlled, gradual increase in range of motion is prferred for the treatment of comminuted intraarticular fracture and acute unstable dislocation of elbow. In comminuted intraarticular fracture of elbow, the Compass Elbow Hinge provides additional stability for fixation devices used to fix intraarticular fractures and simultaneously permits measured and controlled joint mobilization. In instability after reduction of elbow dislocation, the Compass Elbow Hinge helps to protect the soft tissue from undesirable stresses during healing. The purpose of this study is to evaluate the results of the Compass Elbow Hinge in maintaining and restoring mobility in the acutely injured elbow. The authors reviewed 11 consecutive patients who had the Compass Elbow Hinge applied for acute elbow instability. The average duration of application was 7 weeks. Follow-up averaged 18 months, adn motion averaged 96 degrees in flexion/extension plane. Comcentric stability was restored in all but one case, one case of resubluxation required reconstruction of medial collateral ligament, following which, the elbow was stable. According to the Mayo elbow performance index there were 8 excellent, 2 good and 1 fair result. The Compass Elbow Hinge helps to facilitate management of complex osseo-ligamentous injuries of the elbow. It decreases the incidence of sequelae such as stiffness and instability by permitting early mobilization through a kinematically normal range of motion without jeopardizing soft tissue healing.

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The Type and Treatment of Elbow Fractrue in Children: Kyung Chul Kim, Jae Yeul Choi, Joon Sik Kim, Ahn Seok Choi; J Korean Soc Fract 1994;7(1):37-42. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.37

The elbow fractures in children are extremely common and sometimes its are quite difficult to determine the diagnosis. Failure to diagnose adequately and treat fractures of the elbow In children may result in severe complications, such as Volkmanns ischemec contracture, nerve injuries and angular deformity Therefore, accurate reduction without additional trauma and good maintenance are essential by closed or open method. A cllnical analysis was performed on 162 patients with elbow fractures and dislocations in Koryo General Hospital from Jan. 1985 to Jan. 1992. 1. The average age of children was 6 years 9 months, and sex ratio was predominently male(3:1) 2. The most common mechanism was fall from height in 142 cases(88%). 3. Fractures of supracondyle in children was common injuries of the elbow ; 89 cases(55%). 4. Although minimally dlsplaced lateral condyle fracture, the accepted method of treatment was open reduction.

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