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Review
. 2020 May 15;12(5):e8137.
doi: 10.7759/cureus.8137.

Current Management of Paediatric Supracondylar Fractures of the Humerus

Pritom M Shenoy  1 , Amirul Islam  2 , Rahul Puri  3
Affiliations
Review

Current Management of Paediatric Supracondylar Fractures of the Humerus

Pritom M Shenoy et al. Cureus. .

Abstract

Supracondylar fractures of the humerus in children are common and can be distressing injuries to the child, the parents and to the surgical team. Type 1 fractures are managed non-operatively, however displaced fractures (Types 2, 3 and 4) are usually managed surgically. Accurate and repetitive neuromuscular assessment is critical not just for medicolegal reasons but also to expedite management with different specialists if needed. The Rock, paper, scissor, OK technique is simple which is easily understood by most children. We discuss the current evidence with regards to pin diameter, number, pin configuration along with a simple algorithm on how to manage a child with a displaced supracondylar fracture with no pulse focussing mainly on the extension-type fracture.

Keywords: cubitus varus; elbow injury; elbow trauma; fracture in a child; humeral fracture; supracondylar humeral fracture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Motor testing using 'Rock, paper, scissors, OK'
(a) Rock tests the median nerve. (b) Paper tests the radial nerve. (c) Scissors tests the ulnar nerve. (d) OK tests the anterior interosseous nerve. (Photo courtesy P. M. Shenoy)
Figure 2
Figure 2. Gartland classification of supracondylar fractures in children
(a) Type 1, (b) Type 2, and (c) Type 3. (Illustration courtesy P. M. Shenoy)
Figure 3
Figure 3. Radiographic evaluation
(a) Baumann angle (alpha angle), and (b) Anterior humeral line. (Illustration courtesy P. M. Shenoy)
Figure 4
Figure 4. K-wire configuration for fixation
(a) Lateral divergent technique, (b) Cross K-wiring technique, and (c) Dorgan’s technique. (Illustration courtesy P. M. Shenoy)
Figure 5
Figure 5. Treatment algorithm for managing a displaced supracondylar fracture in a child with no pulse
Algorithm by P. M. Shenoy
Figure 6
Figure 6. BOAST guidelines- Supracondylar fractures of the humerus in children
Included with permission [3]. Any follow-up questions with regards to the BOAST guidelines can be emailed to
See this image and copyright information in PMC

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