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

Pediatric Supracondylar Humerus Fractures

Pdf Summary

Pediatric supracondylar humerus fractures are the most common elbow fractures in children and account for nearly 18% of all fractures in this population. These fractures usually occur in children between the ages of 3 and 8 years and are typically caused by a hyperextension load on the elbow from falling onto an outstretched arm. The fracture pattern involves displacement of the distal fragment posteriorly. The clinical presentation includes substantial swelling and an obvious deformity at the elbow. The neurovascular exam is crucial as nerve injuries can be found in up to 15% of patients and vascular compromise can occur in nearly 18.6% of patients. Radiographic imaging should include at least 2 orthogonal views of the elbow to determine the type of fracture and the extent of displacement. The most common treatment for these fractures is closed reduction percutaneous pinning (CRPP), which involves the use of 2 to 3 pins inserted laterally. This method provides stability and reduces the risk of ischemic injury. Delaying surgical treatment for more than 8 hours after a type III fracture can increase the need for open reduction. However, recent studies have shown that a delay of up to 2 to 12 days does not significantly affect patient outcomes. Complications of these fractures include nerve and vascular injuries, malunion, and cubitus varus or gunstock deformity. It is important to closely monitor these fractures for any complications and to ensure that there is anatomic reduction at the time of injury to avoid malunion. Overall, pediatric supracondylar humerus fractures require careful evaluation and treatment to ensure appropriate healing and prevent complications.

Keywords

Pediatric supracondylar humerus fractures

elbow fractures in children

hyperextension load on the elbow

falling onto an outstretched arm

distal fragment displacement

swelling and deformity at the elbow

nerve injuries in patients

vascular compromise in patients

closed reduction percutaneous pinning

complications of supracondylar humerus fractures