supracondylar fractures

Question 1

what is the peak age of incidence?

Answer 1

5-7 years old

most common mechanism is falling on outstretched hand

Question 2

what are the clinical features of supracondylar fractures?

Answer 2

• recent fall or direct trauma, resulting in sudden onset severe pain
• gross deformity, swelling, limited ROM
• eechymosis of anterior cubital fossa
• examine median nerve and interior interosseous nerve, radial nerve and ulnar nerve
• check hand for areas of vascular compromise

Question 3

what investigations can be done?

Answer 3

• plain film radiograph AP and lateral of elbo
• look for posterior fat pads and displacement of anterior humerral line
• CT useful in comminuted fractures of where intra articular extension is suspected

Question 4

how is a supracondylar fractures conservatively managed?

Answer 4

• immediate close reduction

- can do conservative for undisplaced or minimally displaced fractures

Question 5

how is a supracondylar fractures surgically managed?

Answer 5

• in children may need to be preformed in theatre with a K wire fixation
• open fractures warrant open reduction and percutaneous pinning
• vascular injury = refer to vascular surgeons

Question 6

how are supracondylar fractures classified?

Answer 6

the gartland classification system

classifies them as to how displaced the fracture is and in how many planes

Question 7

what are the complications of supracondylar fractures?

Answer 7

• nerve palsies, anterior interosseous nerve is most commonly affected
• malunion, patients may develop cubitus varus deformity (gunstock deformity)
• volkmanns contracture if there is ischaemia and necrosis of flexor muscles of forearm, which eventually fibrose and form a contracture. = wrist and hand held in permanent flexion as a claw like deformity