Supracondylar humerus fracture

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Supracondylar humerus fracture
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Elbow pain, swelling, bruising, deformity
Complications	Compartment syndrome, Volkmann's contracture, nerve injury
Onset	Sudden
Duration
Types	Extension type, flexion type
Causes	Fall on an outstretched hand
Risks
Diagnosis	X-ray
Differential diagnosis	Elbow dislocation, lateral condyle fracture
Prevention
Treatment	Casting, surgery
Medication	Pain management
Prognosis	Generally good with treatment
Frequency	Common in children
Deaths	N/A

Baumann's Angle

Anterior and Posterior Sail Sign

Anterior humeral line

Anterior humeral line in a 6-month-old child

Gartland Classification

A supracondylar humerus fracture is a type of injury that occurs just above the elbow, affecting the distal (lower) part of the humerus bone. This condition is most commonly seen in children, particularly those between the ages of 5 and 7 years old, and is one of the most frequent injuries involving the elbow joint. The mechanism of injury often involves a fall on an outstretched hand, leading to a backward (extension-type) or less commonly, a forward (flexion-type) displacement of the distal fragment.

Classification

Supracondylar fractures are classified according to the Gartland system, which is based on the degree of displacement:

• Type I: The bone is slightly cracked but remains aligned. These fractures are considered non-displaced.
• Type II: The bone is cracked and partially displaced but still maintains some contact between the broken ends.
• Type III: The bone is completely displaced, with no contact between the fractured ends. This type is the most severe and often requires surgical intervention.

Symptoms

Common symptoms of a supracondylar humerus fracture include:

• Severe pain and tenderness above the elbow
• Swelling and bruising around the elbow
• Visible deformity in severe cases
• Limited range of motion in the elbow
• In some cases, numbness or weakness in the hand or wrist due to nerve injury

Diagnosis

Diagnosis of a supracondylar humerus fracture typically involves a physical examination and imaging tests. An X-ray is the primary tool used to confirm the presence and classify the severity of the fracture. In some cases, additional imaging tests such as an MRI or CT scan may be required to assess the extent of the injury and any potential damage to surrounding tissues.

Treatment

The treatment for a supracondylar humerus fracture depends on the type of fracture and the degree of displacement:

• Type I: Non-displaced fractures can usually be treated with immobilization. The arm may be placed in a cast or splint for about 3 to 4 weeks to allow the bone to heal properly.
• Type II and III: Displaced fractures often require surgical intervention to realign the bones. This may involve the use of pins, screws, or wires to hold the bone in place during healing. Following surgery, the arm is typically immobilized for a period of time.

Complications

Complications from supracondylar humerus fractures can include:

• Nerve injury, particularly to the median, radial, or ulnar nerves
• Vascular injury, leading to compromised blood flow to the forearm and hand
• Malunion or nonunion of the fracture
• Elbow stiffness and reduced range of motion

Prevention

Preventing supracondylar humerus fractures involves taking general safety measures to avoid falls and injuries, such as using protective gear when engaging in sports and ensuring safe play environments for children.

See Also

• Elbow dislocation
• Fracture
• Pediatric orthopedics