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Review Question - QID 6076

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QID 6076 (Type "6076" in App Search)
A 5-year-old boy sustained an elbow injury. Examination in the emergency department reveals that he is unable to flex the interphalangeal joint of his thumb and the distal interphalangeal joint of his index finger. The radial pulse is palpable at the wrist, and sensation is normal throughout the hand. Radiographs are shown in Figures 6a and 6b. In addition to reduction and pinning of the fracture, initial treatment should include
  • A
  • B

repair of the posterior interosseous nerve.

1%

8/869

repair of the median nerve at the elbow.

1%

5/869

neurolysis of the anterior interosseous nerve.

1%

11/869

observation of the nerve palsy.

96%

832/869

immediate electromyography and nerve conduction velocity studies.

1%

5/869

  • A
  • B

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The findings are consistent with a neurapraxia of the anterior interosseous branch of the median nerve. This is the most common nerve palsy seen with supracondylar humerus fractures, followed closely by radial nerve palsy. Nearly all cases of neurapraxia following supracondylar humerus fractures resolve spontaneously, and therefore, further diagnostic studies and surgery are not indicated.

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