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Abstract
Supracondylar fracture of the humerus in children is a common childhood injury accounting for 3–7% of all fractures and the majority (55–80%) of all elbow fractures in children.
Primary lesions of the neurovascular structures around the elbow can occur from stretching, entrapping or disrupting the neurovascular structures on the sharp proximal humeral fragment.
In extension type fractures, posterolateral displacement fractures have a predilection of injury to the median nerve and / or brachial artery and posteromedial displacement fractures are more likely to injure the radial nerve. The ulnar nerve is more frequently damaged in a flexion type fracture.
Secondary lesions can also occur in various ways: first, during manipulation of the fracture the nerves can be stretched or entrapped between the fracture ends; second, dysfunction of the nerves can also exist because of swelling of tissues around the elbow irrespective of the treatment.
Iatrogenic nerve injury with medially placed K-wire is a common complication affecting the ulnar nerve during crossed pinning of supracondylar fractures.
Although it can be difficult to quantify disturbances in sensory and motor functions preoperatively, especially in children, it is important to carry out the preoperative assessment of the neurovascular status and should be reported.