Entrapment of the median nerve following elbow dislocation.

Entrapment of the median nerve in the elbow joint is an uncommon complication of dislocation of the elbow in children. Delay in diagnosis has been common. The early signs of median nerve entrapment are the presence of a lesion of the median nerve and pain greater than expected after reduction of an elbow dislocation. The late signs are the presence of a median nerve lesion that is usually complete, elbow flexion contracture, and a bony depression of the distal medial humeral cortex seen roentgenographically that corresponds to the location at which the median nerve travels posterior to the humerus and then enters the elbow joint. If the nerve is intact and one can obtain electrical conduction across the entrapped segment, freeing the nerve and neurolysis should result in recovery. On the other hand, if the nerve is replaced by scar, and there is no conduction across the elbow joint, resection of the damaged segment and reanastomosis is indicated, and has resulted in very good nerve function.