Entrapment of the median nerve within the radius following diaphyseal antebrachial fractures treated with nail osteosynthesis in two paediatric patients

Antebrachial fractures are common among paediatric patients. Some exhibit neurological symptoms, making it initially challenging to determine nerve injury severity. We present two paediatric cases of median nerve entrapment within the radius following mid-shaft antebrachial fractures. Both cases showed persistent sensory and motor deficits, paraesthesia and pain in the distribution area of the median nerve after nail osteosynthesis. Nerve conduction studies and ultrasound suggested nerve entrapment at the fracture site, leading to surgical exploration and nerve autograft repair at 12 months (case 1) and nerve allografting at 34 months (case 2) post injury. At 18 months follow-up, case 1 had regained full sensory function but showed no clinical signs of motor reinnervation. Case 2 regained normal motor function, but sensory function remained impaired at 39 months follow-up. Early recognition and intervention of nerve injuries are crucial for improving the likelihood of better outcomes and minimising the risk of disabling sequelae.