Which nerve is most commonly injured in supracondylar fractures of the humerus?

Explanation

## Neurovascular Complications in Supracondylar Fractures **Key Point:** Median nerve injury is the most common neurological complication of supracondylar fractures, occurring in 10–20% of cases. ### Nerve Injury Frequency | Nerve | Frequency | Type of Injury | Clinical Presentation | |-------|-----------|----------------|----------------------| | **Median nerve** | 10–20% (most common) | Stretch, compression | Loss of pronation, thumb opposition, wrist flexion | | Anterior interosseous nerve (AIN) | 5–10% | Branch of median nerve | Loss of thumb IP flexion, index finger DIP flexion | | Radial nerve | 2–5% | Stretch, rarely transection | Wrist drop (rare in supracondylar) | | Ulnar nerve | 1–3% (least common) | Stretch, iatrogenic during pinning | Intrinsic hand weakness | **High-Yield:** The median nerve is stretched by anterior displacement of the proximal fragment in Type II and Type III fractures. AIN is a branch of the median nerve and may be injured independently. **Clinical Pearl:** Most nerve injuries in supracondylar fractures are **neurapraxias** (stretch injuries) and recover spontaneously within 8–12 weeks. Complete transections are rare (< 1%) and usually require surgical exploration. **Mnemonic:** **"Median = Most common"** — Median nerve injury is the most frequent neurological complication in supracondylar fractures.