Ultrasound is a useful tool to evaluate nerve involvement in children with supracondylar humerus fractures.

Supracondylar humerus fracture (SHF) is a common childhood injury and represents approximately 60% of all elbow fractures in children. Nerve injures associated with this fracture are well-known, and may be a direct consequence of the trauma itself or iatrogenic. Neurophysiological study is the gold standard to assess peripheral nerve injuries but it is invasive and may be difficult to perform in children. Furthermore, neurophysiology can best provide useful information 2-4 weeks post-injury, it does not show nerve anatomy, and is not able to distinguish between axonotmesis and neurotmesis. Nerve ultrasound (US) represents an extension of clinical examination8 and can provide morphologic information. US is being used with increasing frequency to visualize nerves and their surroundings in traumatic nerve lesion, because it helps localize and define the peripheral nerve injury. In particular US can distinguish axonotmesis and neuroapraxia (in which there is nerve continuity) from neurotmesis (in which nerve continuity is absent) to provide information useful for surgery, and it can also facilitate post-operative management.