In pediatric supracondylar humerus fractures, which structures are at risk along with the median nerve?

• A. Brachial artery
• B. Ulnar nerve
• C. Radial nerve
• D. Axillary nerve

Answer: (A)

In these elbow fractures, the structures that lie in front of the distal humerus are at risk, especially the median nerve and the brachial artery. The distal fragment from a supracondylar fracture can compress or transect these structures because they travel together in the anterior compartment around the elbow. Damage to the brachial artery can compromise blood flow to the forearm and hand, so assessing perfusion and pulses is crucial. The other nerves mentioned are less commonly injured in this specific fracture pattern: the ulnar nerve tends to be at risk with medial epicondyle injuries, the radial nerve with lateral or high-energy injuries, and the axillary nerve with injuries higher up the arm.