Can not bend index finger after surgery

My son 7 years old had a Supracondylar Humerus Fracture. 1st surgery set break and pinned. had no radial pulse after pinning. vascular surgeon called in, found clot and damage to artery,Repaired and removed clot. 2nd surgery, they had to preform a fasciotomy. he was cut from upper arm to palm with a small exception in the inner elbow area. due to swelling from mid lower arm to fingers. During this procedure they found another clot and bleeder to repair of artery repaired before.Before the 2 operation he had movement in all fingers. 3rd operation was to close fasciotomy.  Some where between the 2nd after the 3rd operation e lost the ability to bend his index finger, he can only bend it at the first joint closest to the palm. he can not curl finger, it only bends flat from the palm. and is now unusually bending upward and towards the middle finger. First We were told it was due to the pins in his arm/elbow. now after a week of no pins no cast. we are told it may not ever return. I am not happy and fear my sons life will be altered due to something they may have done wrong. Should I pursue other opinions else ware. I believe either the fasciotomy, or the closure of the fasciotomy caused the problem.

[S. Kaul, MD]

Hi there!

Well, the cause of limited finger movement could be related to contractures, fractures, dislocation/ subluxation, tendon or nerve injury. While tendon and nerve injuries could occur during the surgeries, these are also likely to occur secondary to ‘sympathetic dystrophy’ where the damage is often unavoidable. The other causes though common with injuries are unlikely to be related to surgical complications. Also even in the case of tendon/ nerve injuries during surgeries it would be very difficult to say if these were unavoidable. Though I am not sure how bad the situation was; on a personal note, inability to bend the fingers completely may be a minor complication to the odds against the serious risks he was exposed to, due to the injury. Looking at the broader picture things may not be as bad as they seem. You may seek a second opinion with another orthopedician to compare what his/ her thoughts are on the situation after a clinical evaluation and if there could be an appropriate management option.
Hope this helps.

Take care!