Type-V Median Nerve Entrapment in a Pediatric Medial Condyle Fracture

Abstract

Case: A 30-month-old boy with a displaced medial condyle fracture and no history of an elbow dislocation was found to have an entrapped median nerve. Conclusion: Entrapment of the median nerve is a potential consequence of a displaced medial condyle fracture, even when there are no neurologic deficits on presentation. This provides additional support for open reduction of these fractures rather than percutaneous treatment or nonoperative management. Prompt identification and extraction of an interposed ulnar or median nerve is imperative to prevent the catastrophic consequences of an upper-extremity nerve palsy in children, as well as to optimize fracture-healing and elbow growth and development.

Median nerve entrapment in an adolescent medial epicondyle fracture of humerus: a case report

“…Al-Qattan et al[ 8 ] described a Type 4 impingement in a 14-year-old boy with posterior elbow dislocation and medial epicondyle fracture. In a study by McCarthy et al,[ 6 ] median nerve entrapment has been reported in one case of displaced medial condyle fracture in a young child before medial epicondyle ossification. Although the ulnar nerve is usually injured in medial epicondyle fractures, the median nerve may also be compressed between the apophysis part and the distal humerus.…”

“…[ 5 ] Median nerve entrapment has been reported in one case of displaced medial condyle fracture in a young child before medial epicondyle ossification. [ 6 ] To the best of our knowledge, the case described, herein, is the first report of median nerve entrapment in medial epicondyle fracture in an adolescent without elbow dislocation. The aim of our study is to reveal that median nerve entrapment due to medial epicondyle fracture may develop in adolescents without elbow dislocation, although it is extremely rare.…”

Bone‐specific kinetic model to quantify periosteal and endosteal blood flow using indocyanine green in fluorescence guided orthopedic surgery

“…Compact bone is supplied by the periosteal and endosteal blood vessels . The periosteal vessels insert into the periosteum, a connective tissue that surrounds the bone.…”

Current concepts in diagnosis and management of common upper limb nerve injuries in children

“…Incarcerations of the median nerve have also been described in other elbow injuries. McCarthy et al 11 reported on entrapment of the median nerve in a medial condyle fracture, and several authors have published cases of intra-articular median nerve entrapment after elbow dislocation.…”