{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:49:47Z","timestamp":1787755787390,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nerve injuries in pediatric supracondylar humeral (SCH) fractures occur in 2% to 35% of patients. Previous research has suggested that isolated anterior interosseous nerve injuries are not influenced by the time to surgery; however, little is known about other nerve injuries or mixed, motor, and sensory injuries. With this study, we aimed to examine the impact of time to surgery on nerve recovery in patients with traumatic nerve injuries associated with SCH fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients &lt;18 years of age with SCH fractures stabilized using percutaneous pins during the period of January 2009 to June 2022 were retrospectively reviewed. Patients presenting with any traumatic nerve injury noted preoperatively were included, while those with iatrogenic or postoperative nerve injuries and incomplete documentation were excluded. Demographic data, injury characteristics, time to surgery, and number of days to nerve recovery were collected. Comparisons of nerve recovery time by anatomic distribution and functional deficit using an 8-hour time-to-surgery cutoff were made in bivariate and multivariate analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 2,753 patients with SCH fractures were identified, with 214 of the patients having an associated nerve injury. Documentation of nerve recovery was available for 197 patients (180 patients with complete recovery) with an overall mean age of 6.8 \u00b1 2.1 years. Time to recovery differed significantly when comparing the motor, sensory, and mixed-deficit cohorts (p &lt; 0.001). Early surgery (\u22648 hours from injury to surgery) was significantly associated with shorter overall time to nerve recovery (p = 0.002), recovery of multiple nerve distributions (p = 0.011), and recovery of mixed motor and sensory deficits (p = 0.007). On multivariable analysis, mixed nerve deficits (hazard ratio [HR], 0.537 [95% CI, 0.396 to 0.728]; p &lt; 0.001) and time from injury to treatment of &gt;8 hours (HR, 0.542 [95% CI, 0.373 to 0.786]; p = 0.001) were significantly associated with delayed nerve recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Surgical timing impacts the time to recovery of complex nerve injuries. Early surgical management of patients with mixed motor-sensory deficits may help to reduce the time to complete nerve recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.00371","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T14:00:42Z","timestamp":1740060042000},"page":"687-693","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Nerve Recovery in Pediatric Supracondylar Humeral Fractures"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3270-7708","authenticated-orcid":false,"given":"Akbar N.","family":"Syed","sequence":"first","affiliation":[{"name":"Division of Orthopaedics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-7933","authenticated-orcid":false,"given":"David","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7683-3308","authenticated-orcid":false,"given":"Leta","family":"Ashebo","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7995-8139","authenticated-orcid":false,"given":"Divya","family":"Talwar","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2190-6333","authenticated-orcid":false,"given":"Jason B.","family":"Anari","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2538-1626","authenticated-orcid":false,"given":"J. Todd R.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Division of Orthopaedics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"},{"name":"Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"issue":"3","key":"bib1-20250714","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/BPO.0b013e3181d213a6","article-title":"Nerve injuries associated with pediatric supracondylar humeral fractures: a meta-analysis","volume":"30","author":"Babal","year":"2010","journal-title":"J Pediatr Orthop."},{"issue":"1","key":"bib2-20250714","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/01241398-199501000-00011","article-title":"Neurovascular injury and displacement in type III supracondylar humerus 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Outcomes?","volume":"43","author":"Sullivan","year":"2023","journal-title":"J Pediatr Orthop."},{"issue":"3","key":"bib9-20250714","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2106\/00004623-200103000-00002","article-title":"The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children","volume":"83","author":"Mehlman","year":"2001","journal-title":"J Bone Joint Surg Am."},{"issue":"21","key":"bib10-20250714","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.2106\/JBJS.N.00136","article-title":"Supracondylar humeral fractures with isolated anterior interosseous nerve injuries: is urgent treatment necessary?","volume":"96","author":"Barrett","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib11-20250714","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1302\/0301-620X.98B6.35686","article-title":"Nerve injuries associated with supracondylar fractures of the humerus in children: our experience in a specialist peripheral nerve injury unit","volume":"98-B","author":"Kwok","year":"2016","journal-title":"Bone Joint J."},{"issue":"S1","key":"bib12-20250714","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/anae.14140","article-title":"Peripheral nerve injury arising in anaesthesia practice","volume":"73","author":"Hewson","year":"2018","journal-title":"Anaesthesia."},{"issue":"5","key":"bib13-20250714","doi-asserted-by":"crossref","first-page":"660","DOI":"10.3171\/jns.1982.57.5.0660","article-title":"Ultrastructural changes in rat peripheral nerve following pneumatic tourniquet compression","volume":"57","author":"Nitz","year":"1982","journal-title":"J Neurosurg."},{"issue":"3","key":"bib14-20250714","first-page":"205","article-title":"Reducing Tourniquet Pressures in Hand Surgery: Are Lower Pressures as Effective?","volume":"12","author":"Azad","year":"2022","journal-title":"J Wrist 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complicated by peripheral nerve injury","volume":"14","author":"Mohler","year":"2006","journal-title":"J Am Acad Orthop Surg."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:51:24Z","timestamp":1787752284000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.24.00371"}},"subtitle":["Assessing the Impact of Time to 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