Documentation of neurovascular status in supracondylar fractures and the development of an assessment proforma
Emergency Medicine Journal, 07/06/2012

Mayne AIW et al. – Preoperative documentation of neurovascular status in children with displaced supracondylar fractures was poor. Documentation of anterior interosseous nerve (AIN) examination was particularly poor. The introduction of a proforma (Liverpool upper limb fracture assessment) is proposed to increase documentation of neurovascular assessment and optimise emergency department evaluation of children presenting with upper limb injuries.

• A retrospective case–note review was performed on patients with Gartland grades 2 and 3 supracondylar fractures observed in a 2–year period from July 2008 to July 2010.

• 137 patients were included; only 12 patients (8.8%) and 19 patients (13.9%), respectively, had a complete preoperative neurological or vascular assessment documented.
• Regarding the individual nerves, 59 (43.1%) patients had median nerve integrity documented, 55 (40.1%) ulnar nerve and 49 (35.8%) radial nerve integrity documented.
• Only 18 patients (13.1%) had their anterior interosseous nerve (AIN) function documented.