Entrapment of the Median Nerve Following Elbow Dislocation in Children: A Case Series.
10 affiliations
- 1Department of Orthopaedics, Monash Health, Dandenong, VIC 3175, Australia.
- 2Department of Orthopaedics, The Royal Children's Hospital, Parkville, VIC 3052, Australia.
- 3Murdoch Children's Research Institute, Parkville, VIC 3052, Australia.
- 4Department of Surgery, Monash University, Clayton, VIC 3800, Australia.
- 5Department of Plastic Surgery, The Royal Children's Hospital, Parkville, VIC 3052, Australia.
- 6Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia.
- 7Department of Plastic Surgery, Monash Health, Dandenong, VIC 3175, Australia.
- 8Department of Orthopaedics, Bob Dickens Orthopaedic Centre for Education and Research, The University of Melbourne, Parkville, VIC 3010, Australia.
- 9Medical Faculty, University of Basel, 4001 Basel, Switzerland.
- 10School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Melbourne, VIC 3000, Australia.
Abstract
Background and Objectives: Median nerve entrapment following elbow dislocation is a very rare but serious condition in children. We describe four cases of median nerve entrapment, highlight diagnostic challenges, evaluate the impact of delayed treatment, and propose a treatment algorithm. Materials and Methods: A retrospective review of a consecutive case series of four children with median nerve entrapment following elbow dislocation was conducted. Clinical records, imaging, operative findings, and outcomes were reviewed. Results: In all patients, the causative injury was posterolateral elbow dislocation with an associated medial epicondyle fracture. Three patients had delayed diagnosis of their median nerve entrapment (at 10-31 months post-injury) and required nerve resection with sural nerve grafting; none achieved full neurological recovery. One patient underwent early exploration and decompression (at 4 days post-injury) and made a full recovery. Misattribution of neurological symptoms to transient neurapraxia, under-recognition of radiographic signs, and inadequate early advanced imaging contributed to delayed diagnosis and management. Magnetic resonance imaging was the most useful imaging modality for diagnosing median nerve entrapment, though initial reporting missed entrapment in one case. Conclusions: Prompt recognition and early surgical decompression are critical for optimal recovery in paediatric median nerve entrapment after elbow dislocation. Delayed treatment is associated with poor outcomes. We propose a treatment algorithm to guide management and improve outcomes.
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BibTeX
@article{huang2026entrapment,
title = {{Entrapment of the Median Nerve Following Elbow Dislocation in Children: A Case Series.}},
author = {Nathaniel F R Huang and Kemble K Wang and Daniel J Wilks and Danielle Nizzero and Erich Rutz and Jason Harvey},
journal = {Medicina (Kaunas, Lithuania)},
year = {2026},
month = sep,
doi = {10.3390/medicina62101876},
url = {https://europepmc.org/article/MED/42942407},
note = {CC BY},
}
RIS
TY - JOUR
TI - Entrapment of the Median Nerve Following Elbow Dislocation in Children: A Case Series.
AU - Nathaniel F R Huang
AU - Kemble K Wang
AU - Daniel J Wilks
AU - Danielle Nizzero
AU - Erich Rutz
AU - Jason Harvey
PY - 2026
DA - 2026/09/28
JO - Medicina (Kaunas, Lithuania)
DO - 10.3390/medicina62101876
UR - https://europepmc.org/article/MED/42942407
AB - Background and Objectives: Median nerve entrapment following elbow dislocation is a very rare but serious condition in children. We describe four cases of median nerve entrapment, highlight diagnostic challenges, evaluate the impact of delayed treatment, and propose a treatment algorithm. Materials and Methods: A retrospective review of a consecutive case series of four children with median nerve entrapment following elbow dislocation was conducted. Clinical records, imaging, operative findings, and outcomes were reviewed. Results: In all patients, the causative injury was posterolateral elbow dislocation with an associated medial epicondyle fracture. Three patients had delayed diagnosis of their median nerve entrapment (at 10-31 months post-injury) and required nerve resection with sural nerve grafting; none achieved full neurological recovery. One patient underwent early exploration and decompression (at 4 days post-injury) and made a full recovery. Misattribution of neurological symptoms to transient neurapraxia, under-recognition of radiographic signs, and inadequate early advanced imaging contributed to delayed diagnosis and management. Magnetic resonance imaging was the most useful imaging modality for diagnosing median nerve entrapment, though initial reporting missed entrapment in one case. Conclusions: Prompt recognition and early surgical decompression are critical for optimal recovery in paediatric median nerve entrapment after elbow dislocation. Delayed treatment is associated with poor outcomes. We propose a treatment algorithm to guide management and improve outcomes.
SN - 1010-660X
SN - 1648-9144
ER -