Incidence of traumatic and iatrogenic nerve injuries in displaced supracondylar humerus fracture in children

Objective: To estimate the frequency of trauma and treatment induced nerve injuries in cases of displaced supracondylar humerus fractures in children. Materials & Methods: This retrospective observational study was conducted in department of orthopedics, Liaquat National Hospital from January 2011 to December 2015. All the cases of displaced supracondylar humerus fractures in the above mentioned period treated at our institute were analyzed. On a predesigned proforma the age, gender, variety & gartland type of fracture, nerve injuries whether iatrogenic or trauma induced were recorded and data analyzed. Result: 437 patients of displaced supracondylar humerus fractures were identified. Out of which 90 (20.5%) patients had nerve injuries. 54 (60%) patients had trauma induced nerve injury and 36 (40%) had iatrogenic nerve injury. 54.6% were male. Mean age + SD was 7 years. Most common fracture variey was extension 91.1% and most common fracture type was gartland type III 66.7%. Conclusion: Supracondylar fractures have a low to moderate association with nerve injuries. Iatrogenic nerve injury is less common and dependent on method of fixation. Diligent care must be taken for the prevention, early identification and management of these cases.