Supracondylar Fractures of the Humerus

Question 1

What is the presentation of Supracondylar Fractures of the Humerus?

Answer 1

Child falls on an outstretched hand
Elbow swollen + held semi flexed
Damage to the brachial artery may occur
Distal fragment displaced posteriorly - most commonly

Question 2

What is the management of Supracondylar Fractures of the Humerus?

Answer 2

Assess NV status - check radial pulse and sensation of median nerve
No displacement - Flex arm as fully as possible, add a collar + cuff wear for 3 weeks. The triceps act as a sling to stabilise the fragments
Displacement - MUA + K wires + collar + cuff with arm flexed for 3 weeks

Question 3

What complications can occur after a Supracondylar Fractures of the Humerus?

Answer 3

NV injury
Compartment syndrome - esp first 24 hours. Pain on passive extension of fingers, try extension of elbow to relieve. May get Volkmann’s ischaemic contracture → claw hand
Gunstock deformity - Valgus/Varus deformities in the coronal plane do not remodel → cubitus varus (referred to as gunstock deformity)