Pediatric Fractures of the Hand, Wrist, Forearm, and Elbow-Case: Supracondylar Humerus Fractures

Case: Supracondylar Humerus Fractures

Pdf Summary

Supracondylar humerus fractures are common elbow fractures in children, typically occurring after a fall onto an extended arm with hyperextension at the elbow. In this case, an 8-year-old girl fell from monkey bars and sustained a Gartland type III posterolateral extension-type supracondylar humerus fracture. The fracture was classified using the Modified Gartland Classification, which categorizes fractures based on the direction of displacement of the distal fragment. Type II fractures are extended with a posterior hinge intact, while Type III fractures are extended with loss of posterior cortex and no cortical continuity. Nonsurgical treatment is rarely indicated, with immobilization using a long arm being used for Type I fractures with minimal displacement. Most supracondylar humerus fractures are treated with closed reduction and percutaneous pinning (CRPP), with lateral entry pinning using 2 to 3 divergent K-wires being the most prevalent method. Open reduction and internal fixation (ORIF) is indicated in cases of failed closed reduction, loss of pulse or poor perfusion after closed reduction, or open fractures requiring debridement. The patient in this case went to the operating room for CRPP or ORIF, where good reduction was confirmed using intraoperative fluoroscopy. Three lateral entry pins were placed and remained for 4 weeks. At 8 weeks, a motion check was performed, and the patient achieved complete recovery and regain full motion. Overall, supracondylar humerus fractures in children are commonly treated with CRPP, with ORIF reserved for specific indications.

Keywords

supracondylar humerus fractures

elbow fractures

children

fall

Gartland classification

closed reduction

percutaneous pinning

lateral entry pinning

open reduction

motion check