Author/Authors :
-، - نويسنده Pediatric Upper Limb and Microsurgery, Hospital Sant
Joan de Deu Barcelona, Spain Soldado, Francisco , -، - نويسنده Pediatric Upper Limb and Microsurgery, Hospital Sant
Joan de Deu Barcelona, Spain Knorr, Jorge , -، - نويسنده Pediatric Upper Limb and Microsurgery, Hospital Sant
Joan de Deu Barcelona, Spain Haddad, Sleiman , -، - نويسنده Pediatric Upper Limb and Microsurgery, Hospital Sant
Joan de Deu Barcelona, Spain Diaz-Gallardo, Paula , -، - نويسنده Orthopedic Surgery, Hand and Upper Extremity Surgery,
Centre de la Ma de Barcelona (Barcelona Hand Center),
Spain Palau-Gonzalez, Jordi , -، - نويسنده Radiology Department, UIME, Hospital da Luz, Lisboa,
Portugal Mascarenhas, Vasco , -، - نويسنده Pediatric Orthopedic Surgery Department, Hospital
Beatriz Angelo, Lisboa, Portugal Karmali, Samir , -، - نويسنده Pediatric Orthopedic Surgery Department, Hôpital des
Enfants, CHU Toulouse, France Sales De Gauzay, Jerome
Abstract :
Background: Medial pinning is one of the most controversial aspects of the surgical treatment of supracondylar fractures (SHF) owing to the risk of ulnar nerve injury. Aim: To evaluate the safety and usefulness of medial pinning for SHF using ultrasound imaging for ulnar nerve visualization. Methods: Fifteen children, with a mean age of 60 months, with displaced SHF were treated with a crossed-pinning configuration after fracture reduction. Intraoperative ultrasound was used to guide medial pin insertion to avoid ulnar nerve injury. Results: Cubital tunnel anatomy was easily identified in all children. All children showed a subluxating ulnar nerve that required elbow extension to about 90º before medial pin insertion. None suffered ulnar nerve dysfunction after using the referred technique. Conclusions: Although technically demanding, ultrasound may be a valuable adjuvant to avoid ulnar nerve injury while performing a medial pinning in pediatric SHF.
