Late presentation of a partial median nerve palsy following a Gartland III supracondylar humeral fracture.

A 28-year-old male patient was referred to the Peripheral Nerve Injury Unit at the Royal National Orthopaedic Hospital for evaluation and treatment of a neuropathic type pain he had developed in his right arm. Some twenty years previously, he had sustained a Gartland type III supracondylar humeral fracture with what was thought clinically to be an anterior interosseous nerve palsy. The fracture was reduced and the nerve palsy subsequently recovered with non operative measures. At his subsequent delayed presentation, surgical exploration revealed that the median nerve epineurium was embedded within the bone at the level of the previous fracture. A good clinical result was obtained following neurolysis. The case report highlights a late presentation of median nerve palsy following interposition of the neural structure within the reduced distal humeral fracture site; it shows that delayed surgery can be effective.