Supracondylar fracture

Supracondylar Fracture

A supracondylar fracture is a type of bone fracture that occurs just above the condyles of the humerus in the arm. This injury is most common in children and is often associated with significant soft tissue injury, nerve damage, and vascular injury. The supracondylar area of the humerus is susceptible to fracture due to its anatomical structure and the forces exerted upon it during falls or direct impacts.

Causes

Supracondylar fractures are typically caused by a fall on an outstretched hand (FOOSH), with the arm extended and the elbow slightly bent. This mechanism of injury applies excessive force to the elbow region, leading to a fracture just above the elbow joint. In some cases, direct trauma to the elbow from an object or a fall directly on the elbow can also cause a supracondylar fracture.

Symptoms

Common symptoms of a supracondylar fracture include:

• Severe pain and tenderness above the elbow
• Swelling and bruising around the elbow
• Visible deformity or abnormal arm positioning
• Limited range of motion in the elbow
• Numbness or weakness in the hand or forearm, indicating possible nerve involvement

Diagnosis

Diagnosis of a supracondylar fracture is primarily based on physical examination and medical history. X-ray imaging is used to confirm the diagnosis and assess the severity of the fracture. In some cases, additional imaging tests such as CT scans or Magnetic Resonance Imaging (MRI) may be required to evaluate the extent of the injury and associated damages to soft tissues, nerves, and blood vessels.

Treatment

Treatment of supracondylar fractures depends on the severity and type of the fracture. Non-displaced fractures, where the bone pieces remain aligned, may be treated with immobilization using a cast or splint. Displaced fractures, where the bone pieces are misaligned, typically require surgical intervention to realign and stabilize the bones. Surgery may involve the use of pins, screws, or plates to hold the bone fragments in place.

Complications

Complications from supracondylar fractures can include:

• Nerve damage, particularly to the median, radial, or ulnar nerves, leading to weakness or numbness in the hand and forearm
• Vascular injury, which can compromise blood flow to the forearm and hand, potentially requiring emergency treatment to restore circulation
• Malunion or nonunion of the fracture, where the bone heals improperly or fails to heal, necessitating further treatment
• Elbow stiffness and reduced range of motion, which may require physical therapy

Prevention

Preventing supracondylar fractures involves taking general precautions to avoid falls and injuries, such as using protective gear during sports and ensuring safe play environments for children. Teaching children proper techniques to fall safely can also reduce the risk of this type of fracture.