Klinik für Plastische, Hand- und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Plastische und Handchirurgie der Universität Heidelberg, BG-Unfallklinik Ludwigshafen, Ludwigshafen, Germany. andrea.jester@urz.uni-heidelberg.de
Since 1948, closed reduction and osteosynthesis for supracondylar humeral fractures using two K-wires from the medial and lateral side has been performed on a regular basis. Although this procedure is used routinely, many authors have described paralysis of the ulnar nerve after blindly inserting the medial K-wire. Only very few publications describe the treatment options after iatrogenic paralysis of this nerve. The patients described showed progressive paralysis of the ulnar nerve after K-wire osteosynthesis. Intraoperatively, all patients showed scarring but intact continuity. After surgical revision and neurolysis, all four patients showed complete restitution after 1 year. If patients show progressive paralysis of the ulnar nerve early operative revision after 3 months should be performed.