Isolated Radial Nerve Palsy Following Supracondylar Humerus Fracture in a Pediatric Patient: A Case Report.

Supracondylar fractures of the humerus are the most common elbow fractures in children, with a well-documented risk of associated neurovascular complications. While injuries to the median and anterior interosseous nerves are more frequently reported, isolated radial nerve palsy is a relatively rare complication. We report a case of isolated radial nerve palsy following a displaced supracondylar fracture in a pediatric patient, detailing the clinical presentation, management, and outcome. A six-year-old male presented to the emergency department following a fall from a playground, sustaining a displaced supracondylar fracture of the left humerus. On physical examination, the patient exhibited wrist drop and an inability to extend the fingers, consistent with radial nerve palsy. Imaging confirmed a Gartland Type III supracondylar fracture. Closed reduction and percutaneous pinning (CRPP) were performed, with fracture stabilization achieved. Postoperatively, radial nerve palsy persisted but showed gradual improvement over the subsequent weeks. By six weeks, the patient had regained full wrist and finger extension, and radiographs confirmed fracture healing. The patient completed physical therapy and fully recovered with no residual neurological deficits at the 12-week follow-up. This case underscores the importance of timely recognition and management of nerve injuries in pediatric supracondylar fractures. With appropriate treatment, including fracture reduction and comprehensive rehabilitation, children can achieve full neurological and functional recovery from radial nerve palsy.