Supracondylar

fractures
Bui Thi Huong
Group 6- Y3B
Saint Paul Hospital
 he banged his elbow directly on the floor

Case study
 HISTORY OF PRESENT ILLNESS :
13 year-old man is admitted to the hospital
after a falling when playing football. He
complains of an unbearable pain in his elbow.
He banged his elbow directly on the floor.
 Physical examination:
Found that he has an elbow swelling,
bruising on the elbow fold, not bleeding. He
can not fold his elbow. arm, board hand,
finger movement normally.
 Vital sign:
Pulse: 75 per minute; BP: 120/70mmHg;
ToC: 36,8 o C, Breath: 18 per minute.
 Overview

O Supra fractures is a fractures of

distal humerus just above the elbow
joint.
O This fracture pattern is relatively rare
in adults, but is the most common
type of elbow fracture in children
O Diagnosis is confirmed by x-ray
imaging
 Frequency
O Supracondylar fractures constitute
approximately 50% of all elbow
fractures, 3% of all fractures
O The supracondylar region is thin and
weak and thus it can fractures easily.
 Fracture types
Extension type Flexion type
 Extension type
O Most common type (95%)
O Occur due to galling onto an
outstretched hand
O The distal fragment displaces
posteriorly
O Anterior interosserous neurapraxia is
the most common nerve palsy
occurring with supracondylar
fractures
 Extension type
O Injury to the anterior interosseous
nerve will lead to weakness of flexor
digitorum profundus muscle to the
index and the flexor pollicis longus
muscle
O The patient cannot bend the tip of
his index finger
O Radial nerve neurapraxia is the
second most common palsy and is
envident by weakness in wrist and
finger extension
 Flexion type

O It is rare and occur due to falling

derectly on a flexed elbow
O The distal fragment is displace
anteriorly
O This type of fracture may be
accompanied with ulnar nerve will
lead to loss of sensation along the
little finger
O Latter on the pation may also hace
weakness of the intrinsic hand
muscle and clawing
Anatomy
Anatomy
Nerve
Gartland classification system
 Radiology
O X- rays should be obtained
O A posterior fat pad sign should increase
your suspicion of an occult fracture
around the elbow
Baumann’s Angle
 Examination
O It is very important to assess the
neurovascular structures.
O The Anterior nerve is assessed by asking
pation to do the OK sign with his hand.
 Examination
- The Radial nerve is assessed by loss
of sensation along the little finger.
 The Ulnar nerve is initially assessed by loss of sensation along the little finger.
Later on the patient may also weakness of the intrinsic hand muscle and clawing.
 Treatment
O Non- operative treatment
- Indicated for type I fractures
- Usually consists of splinting or casting
the elbow for a duration of 3-4 weeks.
- It is very important to remember not
to flex the elbow in the splint or cast
beyond 90 degrees in order to advoid
vascular compromise and
compartment syndrome.
 Treatment
O Operative treatment
- Type II and III fractures are usually
treated by close reduction and
percutaneous pinning.
- During reduction, pronation of forearm
during elbow flexion helps to correct a
varus deformity
 Tham khảo
O [1] Supracondylar Fractures Of The
Humerus In Children
https://www.youtube.com/watch?
v=Z46LtJko9SY&t=355s
O [2] Cấp cứu ngoại khoa Đại hoc Y Hà
Nội
O [ 3].Cambell orthopedic opreation
O [4] Gartland classification system