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Supracondylar fracture

Natasha Nayak

Created on July 31, 2023

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Supracondylar Fractures

AKA Elbow Fractures

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A supracondylar fracture is a break in the humerus, the long bone in the upper arm, just above the elbow joint. It is the most common type of elbow fracture in children, accounting for about 50% of all elbow fractures in this age group.

What we'll go over

Pathophysiology

Clinical Presentation

Radiographic Evaluation & interpretation

Management

Summary and Additional resources

The Elbow

rare, only 5 %

Play

Flexion Type Supracondylar Fracture

Fall on an oustretched hand

FOOSH Injury

How will the child how the arm?

What will the children come in with?

Most common ages

Child will usually hold arm straight in pronation and refusing to use the arm or flex at the elbow

Most commonly between ages 3 and 10, with peak incidence between 5 and 7 due to relative strength of the collateral ligaments and joint capsule as compared to the elbow

+ info

Most of these injuries occur after falling from a height (bed, monkeybars, etc.). Kids will immediately report pain, swelling and inability to strengthen the elbow.

Pucker Sign

Puckering, dimpling, or ecchymosis of the skin anterior to the distal humerus Indicates that the proximal fragment has penetrated the brachialis muscle (Brubacher 2008)

S shaped deformity

Occurs when the fracture is completely displaced at the distal humerus

What will you see on exam?

Extra concerning signs

Clinical assessment

Localized swelling and tenderness, with or without deformity of distal humerus

Presence of extensive swelling and ecchymosis of elbow imparts a significant risk for compartment syndrome

Broken bone, so what?

Radial pulse must be assessed by palpation or in some instances by Doppler ultrasonography. An absent radial pulse may be due to vasospasm of the brachial artery or injury or kinking over the fracture spike.

Neurovascular Exam

Gartland Classification

X-Ray Interpretation

Most commonly with CRPP or open reduction if needed

CRPP

Cast immobilization x 3-4 weeks. Follow up xrays in 1 week

Treatment

Timeline

20XX

Plan

20XX

Structure

20XX

Design

20XX

Communicate

20XX

Impress

Volkman's Ischemic contracture

Complications

Pin migraiton

Cubitus Valgus Deformity

Nerve Palsy

Cubitus Varus Deformity

Infection

Vascular Injury

Interactive question

Core EM. (2015, January 15). Pediatric Supracondylar Fractures. Retrieved July 31, 2023, from https://coreem.net/core/pediatric-supracondylar-fractures/.

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