A case presentation and a brief review of supracondylar fractures of humerus

1. Supracondylar Fracture of
Humerus;
a Case Presentation
and a Brief Review
Farbod Zahedi Tajrishi
Babol University of Medical Sciences
Nov. 2015

2. Case
• 11-year-old school-boy
• Falling on outstretched hand while playing in
school
• Referred with his mother as company
• Had a radiograph with them which showed
supracondylar fx. of left humerus

3. Presentation and Physical Exam
• Pain, tenderness, inflation & deformity in the
distal part of left arm (elbow region)
• Other extremities were NL
• NL Color & temp. of the affected extremity
• NL radial, ulnar & brachial pulses
• NL Capillary filling
• NL radial, ulnar, median & musculocutaneous
nerves (motor & sensory)

4. Orders and Taken Actions
• IV line
• AP & lat. X-ray of left elbow
• Full-length x-ray of left arm & forearm
• Reduction
• Splint (in neutral position)
• Ice pack, elevation
• N/V check every 1 hour
• NPO and OR list registration

5. Diagnosis and typing
• Supracondylar fx. of left humerus
• AO classification: 13A2
• Extension type
• Angulation + / displacement + / rotation +
(posterolateral movement)

6. Epidemiology
- Mostly seen in children (mostly boys)
- Only 3% of all fractures in adults
- Peak age: 5-7
- Left or non-dominant side predominates

7. Etiology
- Supracondylar area is vulnerable because:
1. the bone in this area is less cylindrical
2. Laxity of ligaments permits hyperextension
And …
- Two types:
1. Extension type (more common)
2. Flexion type

8. Clinical Presentation
- Elbow deformity
- Edema
- Ecchymosis
- Tenderness in fx. Site
- Crepitation
- Limited motion of elbow

9. Treatment
- Splint / long cast if no displacement
- Surgical fixation with pin if displaced, 3-week cast after
surgery, 3-week sling after removing the cast
!! Elevation is necessary after casting or surgery in order to
regulate bloodstream and reduce inflation.

10. Complications
- Compartment syndrome
- Brachial artery injury -> Volkmann Ischemic Syn.

11. Complications
- Nerve injury (usually reversible) : median &
radial in ext. type / ulnar in flex. type
- Malunion -> Cubitus Varus deformity (tx:
surgery)

12. Complications
• Myositis Ossificans

13. Thanks for your time and
attention
Farbod Zahedi Tajrishi
Nov. 2015