Neiman R, Maiocco B, Deeney V F
Department of Orthopedic Surgery, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana 70121, USA.
J Pediatr Orthop. 1998 Sep-Oct;18(5):683-5. doi: 10.1097/00004694-199809000-00026.
We treated two children with the unusual complication of ulnar nerve palsy after closed both-bone forearm fractures. Both patients developed an ulnar claw-hand deformity within 7 weeks of injury that resolved spontaneously by 20 weeks postinjury with nonoperative treatment. No patient showed any signs or symptoms of an ischemic compartment syndrome. Both nerve injuries were identified immediately at the time of fracture by a careful neurologic examination. This avoids confusion with a postreduction nerve entrapment injury or ischemic injury after a localized compartment syndrome, which may have considerably different treatments and outcomes. We recommend that a careful neurologic examination be recorded before any manipulative reduction of forearm fractures in children. If an ulnar nerve palsy is detected, it is probably a result of nerve contusion and should resolve without the need for surgical exploration.
我们治疗了两名闭合性双骨折前臂骨折后出现尺神经麻痹这一罕见并发症的儿童。两名患者均在受伤后7周内出现尺侧爪形手畸形，经非手术治疗后在受伤后20周时自行缓解。两名患者均未出现任何缺血性肌间隔综合征的体征或症状。在骨折时通过仔细的神经学检查立即发现了这两处神经损伤。这避免了与复位后神经卡压损伤或局部肌间隔综合征后的缺血性损伤相混淆，因为它们可能有截然不同的治疗方法和结果。我们建议在对儿童前臂骨折进行任何手法复位之前记录仔细的神经学检查情况。如果检测到尺神经麻痹，很可能是神经挫伤的结果，无需手术探查即可自行缓解。
