Malfixed Supracondylar Humeral Fracture

Above – Pre op.
A malfixed supracondylar humeral fracture with a partial median nerve injury. 3 weeks from injury. Spontaneous pain and dysthesia noted in thumb and index finger. No sympathetic function in the fingers- no sweating, dry red skin AIN palsy and weakness of thumb abduction.

 

Operative exposure of median nerve – nerve removed from fracture – 2cm length of hard neuroma noted. Revision fixation performed then median nerve primary repair in elbow flexion. Elbow gradually extended.

Follow up:
at 6 days – pain gone
at 6 weeks – recovery of majority of sensation (7-8/10)
at 6 months – sensation 9/10 and AIN motor recovering
at 9 months – full normal hand function and full ROM at elbow forearm and hand

Insight

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