Radial nerve palsy due to supracondylar open fracture in a child

Description

A 9-year-old boy presented to the emergency department with severe left elbow pain after a fall from a skateboard. On physical examination, an open injury in his left elbow that exposed the humeral lateral epicondyle was observed (Gustilo grade; figure 1A). The radial pulse was well palpated, but the neurological diagnosis was impossible because of severe pain.

Figure 1

(A) The clinical photograph depicts the open injury on the left elbow. (B) The lateral radiograph shows supracondylar fracture that was remarkably displaced. (C) The anteroposterior radiograph shows supracondylar fracture that was remarkably displaced. (D) The clinical photograph depicts the tenting radial nerve.

A radiograph revealed a supracondylar humeral fracture in which the distal fragment was remarkably displaced (Figure 1B, C). After adequate preanaesthetic clearance, the patient was planned for surgery. On further exploration, the radial nerve was tenting strongly by the displaced bone...

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