Elbow Injuries - Supracondylar Fractures Extension

Authors: Melody Glenn, MD, Andrew Little, DO, Mary Haas, MD
Updated: 12/12/2016

Elbow Injuries: Supracondylar Fractures Extension

Type 1 through 3 supracondylar extension fractures

X-ray views

  • Elbow: AP and lateral.
  • Forearm: AP and lateral.

Assess for indirect signs of fx on lateral elbow view:

  • Sail sign or posterior fat pad.
  • Anterior humeral line no longer intersects middle third of capitellum.

Acute Management

Long arm posterior splint in position of comfort.

Follow Up Timing

Non-displaced fracture: Urgent orthopedic follow-up in ≤2 days. Displaced fracture: Hospital admission for serial neurovascular exams and operative stabilization.



  • Type I: Non-displaced/
  • Type II: Displaced with intact posterior cortex.
  • Type III: Complete displacement (both anterior and posterior cortex).


  • Median (anterior interosseous nerve branch), ulnar, or radial nerve injury.
  • Malunion causing deformity, Volkmann contracture.

Extension more common in children.