supracondylar fractures of the elbow

Question 1

supracondylar region of the distal humerus

Answer 1

is a relatively weak point in the growing upper limb so supracondylar elbow fractures are fairly common

Question 2

which supracondylar fractures are most common

Answer 2

extension type fractures are more common and occur due to a heavy fall onto an outstretched arm, flexion types are rarer and occur due to a fall onto the point of a flexed elbow

Question 3

undisplced supracondylar fractures

Answer 3

are stable and are treated with a splint

Question 4

angulated rotated or displaced supracondylar fractures

Answer 4

require closed reduction and pinning with wires to prevent deformity

Question 5

in severely displaced/ off ended fractures

Answer 5

the brachialis muscle may be tethered in the fracture site which requires open reduction if the fracture cannot be reduced by closed means

Question 6

in off-ended extension type fractures

Answer 6

the distal fragment displaces posteriorly which stretched and puts pressure on the brachial artery and the median nerve (predominantly the anterior interosseous branch)

Question 7

what happens due to stretch of the median nerve

Answer 7

patient is unable to make ok sign due to loss of flexor policies longus and flexor digitorum profundus

Question 8

displaced supracondylar fractures management

Answer 8

should be reduced quickly to avoid soft tissue swelling

Question 9

what can be absent or reduced in supra- condylar fractures

Answer 9

the radial pulse which is a surgical emergency

Question 10

majority of nerve injuries in supracondylar fractures

Answer 10

are neuropraxias or axonotmesis and eventually will improve but if no improvement or neuralgic pain this may indicate nerve entrapment and requires surgical release