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Review
. 2021 Jul;31(5):871-881.
doi: 10.1007/s00590-021-02932-2. Epub 2021 Mar 20.

Overview of the contemporary management of supracondylar humeral fractures in children

Sean Duffy  1 , Oliver Flannery  1 , Yael Gelfer  2 , Fergal Monsell  3
Affiliations
Review

Overview of the contemporary management of supracondylar humeral fractures in children

Sean Duffy et al. Eur J Orthop Surg Traumatol. 2021 Jul.

Abstract

Purpose: Supracondylar fractures are common injuries accounting for approximately 15% of all fractures in children with a large body of literature on this subject.

Methods: This article critically appraises the available evidence to provide an overview of the treatment options including the role and timing of surgery, the geometry of wire fixation and the management of nerve and arterial injury.

Conclusion: Management decisions are based on a number of considerations particularly fracture stability. Closed reduction and percutaneous K-wire stabilisation are commonly recommended for an unstable displaced fracture. These techniques are however associated with the potential for iatrogenic neurological injury. Vascular injury is also rare but must be recognised and treated promptly to avoid significant permanent morbidity.

Keywords: Cubitus Varus; Neurovascular; Review; Supracondylar; Treatment.

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Conflict of interest statement

All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The modified Gartland classification system a type I non-displaced, b type II moderately displaced, posterior cortex remains in continuity (IIa no rotation, IIb rotation), c type III complete displacement and d type IV unstable in flexion/extension (intraoperative discovery)
Fig. 2
Fig. 2
Anterior humeral line (AHL, yellow dotted line) passing in front of the capitellum suggesting posterior/extension displacement of the distal humerus
Fig. 3
Fig. 3
Flexion type supracondylar fracture
Fig. 4
Fig. 4
Crossed wires used to stabilise a high medial (reverse oblique) fracture pattern
Fig. 5
Fig. 5
Gartland III (AO 4) injury with posteromedial displacement
Fig. 6
Fig. 6
Exploration of the brachial artery and median nerve for neurovascular injury
Fig. 7
Fig. 7
Management flowchart for supracondylar fractures related to adequate and inadequate perfusion
See this image and copyright information in PMC

References

    1. Gartland JJ. Management of supracondylar fractures of the humerus in children. Surg Gynecol Obstet. 1959;109(2):145–154. - PubMed
    1. Cheng JC, Shen WY. Limb fracture pattern in different pediatric age groups: a study of 3350 children. J Orthop Trauma. 1993;7(1):15–22. - PubMed
    1. Cheng JC, Ng BK, Ying SY, et al. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop. 1999;19(3):344–350. - PubMed
    1. Beaty JH and Kasser JR (2006) Rockwood and Wilkins’ Fracture in Children. 6th Edition, Lippincott-Raven, Philadelphia.
    1. Barr LV. Paediatric supracondylar humeral fractures: epidemiology, mechanisms and incidence during school holidays. J Child Orthop. 2014;8(2):167–170. - PMC - PubMed

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