Journal of Musculoskeletal Trauma

Ulnar nerve palsy After Percutaneous Pinning in Childrens Supracondylar fracture: Tai Seung Kim, Jay Rim Choi, Kuhn Sung Whang; J Korean Soc Fract 1999;12(3):674-678. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.674

Abstract PDF: Many authors have described percutaneous pinning techniques as the treatment of choice for most supracondylar fractures. But little information is available concerning ulnar nerve injury resulting from pinning techniques. When the surgeon is faced with a postoperative ulnar nerve palsy, it can be the result of unrecognized preoperative palsy, manipulation during surgery, or damage to the nerve by one of the medial pin placements. The options for management include exploration, medial pin removal, or observation. We reviewed our hospital records on the 132 supracondylar elbow fractures that we treated in children from 1991 to 1998 There were 16 palsies found with normal preoperative and abnormal postoperative ulnar nerve function. Normal nerve function returned without exploration and early medial pin removal in all cases. We recommand that observation is the appropriate way to manage these postoperative ulnar nerve palsies in most cases.

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Tardy Ulnar Nerve Palsy Caused by Post-Traumatic Elbow deformities: Seung koo Rhee, seok Whan Song, Hwa Sung Lee, Ho Tae Kim; J Korean Soc Fract 1998;11(2):420-426. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.420

Abstract PDF: Thirty-five patients with tardy ulnar nerve palsy caused by cubitus valgus (33 cases0 and varus (2 cases) deformities were retrospectively studied. All patients had a history of old fracture on the distal humerus during childhood. The mean interval between the previous fractures and the onset of ulnar neuropathy was 19 years. The severity of nerve palsy was classified as McGowan's grade I in 24 patients, grade II in 8 patients, and grade III in 3 patients. The mean carrying angle was average 29 degrees in 33 cases with cubitus valgus and it was decreased to average 11 degrees postoperatively, but the angle was average -23 degrees preoperatively in 2 cases with cubitus varus and it was corrected to average 9 degrees postoperatively. the cause of palsy was analysed by mechanical stetching in 11 cases, compression by a fibrous band between the two heads of flexor carpi ulnaris in 8 cases, and diffuse fibrous adhesion around the ulnar tunnel in 5 cases. All patients was treated with supracondylar closing wedge osteotomy accompanied with anterior ulnar nerve transposition in 13 patients, corrective osteotomy only in 12 patients, and anterior ulnar nerve transposition only in 10 patients. Their end results were analysed as good in 24 cases, fair in 8 cases, and poor in 3 cases within average 6 months after the operations (4 to 13 months). The poor results was obtained in 3 cases out of 9 cases with corrective osteotomy group (33.3%). Conclusively, a tardy ulnar nerve palsy caused by post-traumatic elbow deformities should be corredcted with anterior ulnar nerve transposition with or without corrective closing wedge osteotomy but not by corrective osteotomy only, because of compressive neuropathy by diffuse fibrous adhesion or bands of two heads of FCU around the ulnar tunnel in elbow.

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Fracture of the Distal Radius with Ulnar Nerve Palsy: Chil Soo Kwon, Jong Kuk Ahn, Jin Hyok Kim, Yerl Bo Sung, Jin Ho Cho; J Korean Soc Fract 1997;10(1):171-174. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.171

There are several complications of distal radiug fracture such as median nerve injury, malunion nonunion, rupture of EPL, and ischemic contracture. Lesion of ulnar nerve as a complication of fracture of the distal radius are very rare. The authors report 1 case of the distal radius fracture with ulnar nerve palsy. The electromyography & nerve-conduction studies showed incomplete axonotmesis of ulnar nerve on 1 month following injury. A second electromyography & nerve-conduction study two months after injury showed complete recovery of nerve function.

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Ulnar Nerve Palsy Following Closed Fracture of the Distal Radius: A Report of 2 Cases
Chul-Hyun Cho, Chul-Hyung Kang, Jae-Hoon Jung
Clinics in Orthopedic Surgery.2010; 2(1): 55. CrossRef

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Treatment of Fractures of Lateral Condyle of Humerus with Compliations: Moon Sang Chung, Sung Churl Lee; J Korean Soc Fract 1995;8(3):659-666. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.659

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Fractures of the lateral condyle of the humerus are notorious for complications, most commonly nonunion with subsequent proximal migration of the ununited fragment, an increase in the carrying angle, and the tardy ulnar nerve palsy. In the past, the reconstructive surgery for complicated old fractures of the lateral condyle of the humerus had been hardly considered, but recently, attempts have been made to reconstruct the anatomy and function of the elbow joint. The authors have reviewed 21 cases of old fractures of the lateral condyle of the humerus, which had been treated at Seoul National University Hospital from April,1982 until March, 1990. For established nonunions of the lateral condyle fragment, better results were obtained from the procedure that includes osteosynthesis of the lateral condyle, attempting to restore the normal anatomy of the elbow joint. For tardy ulnar nerve palsies, better results were obtained from the procedure that includes medial epicondylectorny. Fractures of the lateral humeral condyle have many late problems in spite of treatment at the time of injury so early aggressive treatment is necessary. Even in cases with late problems, aggressive treatment should be done, too, as soon as possible.

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In SituLate Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children
Kun Bo Park, Seung Whan Lee, Hyun Woo Kim, Hui Wan Park, Ki Seok Lee
Journal of the Korean Fracture Society.2008; 21(2): 151. CrossRef

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