Elbow Injuries: Supracondylar Fracture Flexion

X-ray Views

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

Acute Management

Long arm posterior splint in position of comfort.

Follow-up Timing

Type I: Orthopedic follow up in ≤7 days Displaced fracture: Consult orthopedicsurgeon to discuss, because no evidence on best treatment plan for adults and children (closed reduction plus immobilization vs operative).

Notes

Classifications

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

Flexion type (compared to extension) more likely to need operative repair in children.

Complications: Ulnar nerve entrapment and injury.

Less common overall, more common in adults.

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.