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A 4-year-old male falls from monkey bars and sustains an extension supracondylar humerus fracture with a neurologic deficit. Which of the following muscles is most likely affected?
Extensor digitorum communis
Flexor carpi radialis
Flexor digitorum profundus to small/ring fingers
Flexor carpi ulnaris
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Anterior interosseous nerve injury is the most common nerve injury seen in extension type supracondylar humerus fractures in children. The anterior interosseous nerve innervates flexor pollicis longus, flexor digitorum profundus to the index and long fingers and pronator quadratus.
Seror describes a consecutive series of 13 patients with lesions of the anterior interosseous nerve. Based on the difficulty of diagnosis and evaluation, these patients are most frequently misdiagnosed with tendon injuries. In his series, only 3 patients had a correct initial clinical diagnosis, and the most common electrophysiological abnormality found was in the innervation of pronator quadratus.
J Bone Joint Surg Br. 1996 Mar;78(2):238-41. PMID: 8666633 (Link to Abstract)
Seror, BJJ 1996
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