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KMID : 0361620080430020240
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Journal of the Korean Orthopaedic Association
2008 Volume.43 No. 2 p.240 ~ p.246
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Neuro-vascular Injuries Associated with Supracondylar Fractures of the Humerus in Children
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Kim Jung-Ryul
Jeong Woo-Chul
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Abstract
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Purpose: Supracondylar fractures in children have the potential for associated neuro-vascular injuries. It is important to diagnose and manage these fractures because they are often underestimated when assessing a painful elbow in agitated children. This study focused on evaluating the frequency of neuro-vascular injuries associated with fracture displacement, and to define a therapeutic strategy.
Materials and Methods: From January 1997 to December 2006, 128 children who were available to follow up were examined restrospectively. The incidence of neuro-vascular injuries was investigated, and the types and displacement of fractures were classified. The therapeutic strategy and complications were also defined.
Results: Neuro-vascular complications occurred in 24 patients. Seventeen, 12, 4, 4 and 1 patient had only neural injuries, radial, ulnar, median, and anterior interosseous nerve. There were 4 patients with both neural and vascular injuries, and 3 patients had only vascular injuries. Most neural injured patients had recovered completely, but 1 patient had not recovered after 6 months. Therefore, exploration and sural nerve graft was performed.
Conclusion: The frequency of neuro-vascular injury is a result of severely displaced supracondylar fracture. A therapeutic strategy for supracondylar fractures in children is proposed to minimize complications.
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KEYWORD
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Children, Humerus, Supracondylar fracture, Displacement, Neuro-vascular injury
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