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.

Notes

Classifications

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

Complications

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

Extension more common in children.

References

Wheeless’ Textbook of Orthopaedics. Available at: http://www.wheelessonline.com/ortho/pediatric_supracondylar_fractures_of_the_humerus. Accessed August 1, 2017.
Orthobullets. Available at: http://www.orthobullets.com/pediatrics/4007/supracondylar-fracture--pediatric. Accessed August 1, 2017.
Radiopaedia. Available at: http://radiopaedia.org/articles/supracondylar-fracture. Accessed August 1, 2017.
General Guidelines For Management for Orthopedic Injuries card by the Nationwide Children’s Hospital, Dept of Orthopedics.