What You Need to Know About Supracondylar Fractures

Supracondylar fractures occur just above the elbow on the humerus. Such types of fractures are known to be common in children thus, are also considered as common pediatric elbow injuries. The age at which supracondylar fractures occur the most is between 5 and 7 years, while the occurrence of these types of fractures is rare in adults.

For the surgical treatment of supracondylar fractures, Closed reduction with percutaneous pinning method could be used plus, the use of Supracondylar Nailing System is also seen.

Causes of Supracondylar Fractures

The most common cause of supracondylar fracture is falling on an outstretched hand where the elbow is in extension. This type of fracture could also occur due to falling on the flexed elbow but the chances of occurrence of supracondylar fracture in such a case are very low. Certain complications associated with the injury may include injury to blood vessels and nerves along with malunion.

Classification of Supracondylar Fracture

The classification of supracondylar fracture based on modified Gartland classification (2006) includes:

Type I

These types of supracondylar fractures are non-displaced or minimally displaced. The anterior humeral line remains intact in case of type I fractures whereas the displacement is seen less than 2mm.

Type II

This condition is characterized by more than 2mm of displacement and no rotational deformity is seen.

Type III

Displacement is seen in type III supracondylar fracture but without any meaningful cortical contact. In this case, disruption of periosteum and soft tissue & neurovascular injuries are also seen.

Type IV

This type could be regarded as the most severe one as it is characterized by multidirectional instability along with the instability in flexion and extension.

Symptoms of Supracondylar Fractures

Some of the symptoms seen in case of supracondylar fractures include:

• Sudden and extreme pain in elbow and forearm
• Swelling near the elbow
• Numbness in the hand
• Inability to move the arm

Diagnosis of Supracondylar Fractures

During the physical examination, if the doctor finds symptoms of supracondylar fracture, then he/she will suggest an X-ray to get a detailed look at the injured site. X-ray examination will tell the correct location of the fracture and the doctor can further decide which treatment method to be chosen. After identifying the fracture in X-ray examination, the doctor will classify it based on the Gartland classification system.

The Treatment

Just like many other fractures, the treatment of supracondylar fracture will depend upon the severity of the condition. In case of mild injuries like type I or type II, non-operative treatment is the most preferred one.  For non-operative treatment, a cast or splint is applied to immobilize the bone while allowing the natural healing process to occur. Before application of a cast, the doctor will wait for swelling to disappear and until then, he/she may apply a splint. Besides this, it is also important to realign the bones before splint application, and to achieve that, the doctor will first give anesthesia to the patient.

Now, in case of severe cases where the displacement of fractured bones is high, surgery may be required. To treat this condition surgically, two options are there:

• Closed reduction with percutaneous pinning
• Open reduction with internal fixation

With percutaneous pinning, the surgeon will insert pins through the skin to hold fractured bone fragments in their correct alignment. This is the closed reduction method of treatment and is known to be the commonest of the two. This treatment procedure is followed by the application of a splint for around one week and it is replaced with a cast.

While on the other hand, open reduction and internal fixation are done when the damage is more severe and has affected nerves or blood vessels. Sometimes, the Supracondylar Nailing System may also be used during the surgical treatment.

Siora Surgicals is a well-established manufacturer of Supracondylar Nailing System along with other Orthopedic Trauma Implants including Intramedullary Nail and Antegrade Interlocking Nail.