Supracondylar Fracture Flashcards
In which people are supracondylar fractures common in
Paediatrics
MOI - FOOSH with elbow extension
what is the epidemiology of this fracture
Peak age - 5 to 7
MOA: FOOSH
What are the clinical features of supracondylar fracture
Sudden onset pain
Gross deformity
Swelling
Limited range of elbow movement
ecchymosis of the anterior cubital fossa
Examination:
- assess for median nerve damage
- anterior interosseous nerve (the deep motor branch of the median nerve), the radial nerve, and the ulnar nerve.
How do you check for vascular compromise after supracondylar fracture
cool temperature, delayed capillary refill time, or absent pulses
What are the differential diagnosis
Distal humeral fractures
Olecranon fractures
Soft tissue injury
Subluxation of the radial head
What are the investigations needed to be carried out
Plain film radiographs in AP and lateral view of elbow
CT if comminuted fracture
what are the signs on X ray of a supracondylar fracture
Posterior fact pad
Displacement of the anterior humeral line
What is the classification used for supracondylar fracture
Garland classification
Type 1 - 4
Give a overview of the gartland classification
Type 1 - undisplaced
Type 2 - displaced with an intact posterior cortex
Type 3 - displaced in 2/3 planes
Type 4 - displaced with complete periosteal disruption
How do you manage supracondylar fractures that are associated with neurovascular compromise
Immediate closed reduction in theatre which is secured with K wire fixation
What is the management for type 1 and 2 fractures
Above elbow cast in 90 degree flexion
What is the management for type 2-4 Fractures
closed reduction and percutaneous K-wire fixation.
How do you treat open supracondylar fractures
open reduction with percutaneous pinning
what are the complications of supracondylar fractures
Nerve Palsies - Anterior interosseous nerve
Mal union
Cubitus Varus deformity - often termed gunstock
Volkmanns contracture - due to ischaemia and subsequent necrosis - leads to fibrosis and forms a contracture - results in wrist and hand being in permanent flexion - claw like deformity
