Your childs humerus is fractured broken near the elbow area, just above the joint. Supracondylar fracture pediatric pediatrics orthobullets. Kids broken elbow supracondylar fracture bone talks. Fracture, supracondylar humerus childrens hospital colorado. This paper describes the techniques employed in the surgical treatment of pediatric supracondylar humerus fractures. Supracondylar fractures are the most common type of upper arm injury in children. By california orthopaedic association featuring coleen sabatini. Understanding the anatomy, radiographic findings, complications, and management options associated with this fracture allow physicians to limit the morbidity associated with this injury. Melissa nebzydoski do, in the sports medicine resource manual, 2008. Supracondylar fracture of the humerus is a common childhood injury to the elbow. The mainstay of investigation for suspected supracondylar fractures is via plain film radiographs in both anteroposterior ap and lateral views of the elbow. Sickkids parent information sheet supracondylar humerus fracture without displacement.
The treatment of pediatric supracondylar humerus fractures. Supracondylar humerus fractures are a common elbow injury, constituting. A free powerpoint ppt presentation displayed as a flash slide show on id. On the lateral side this can result in a dislocation or a fracture. Before the age of two, the low supracondylar fracture is an entity tobewareof, as thelargely unossi. Radiographs of the elbow show a displaced supracondylar fracture. Complications may include injury to an artery or nerve, and compartment syndrome the cause of a humerus fracture is usually physical trauma such as a fall. Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which require vigilance as imaging findings can be subtle.
Pdf management of supracondylar fracture of humerus with jess. The association with neurovascular compromise and the potential problems of accurately reducing a displaced fracture can make treatment difficult particularly for the unwary surgeon. Displaced supracondylar humerus fractures in children. While nondisplaced fractures can be managed nonoperatively, both closed and open surgical reduction techniques are indicated when fractures are displaced or associated with neurovascular injury. Posterior fat pad sign lucency visible on the lateral view. There was a substantial increase in operating time in the medial spike group, however no difference in the mode of reduction and composite outcome between the two groups. Supracondylar fracture of humerus ortho the best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration.
Supracondylar fractures of the humerus are one of the most common fractures of childhood. Status post closed reduction and percutaneous pinning of this displaced supracondylar humerus fracture. A humerus fracture is a break of the humerus bone in the upper arm. Prognostic factors for the outcome of supracondylar. Pdf supracondylar fractures of the humerus in children. Supracondylar fracture teachmesurgeryteachmesurgery.
Crosssectional study of gartland ii and iii humerus supracondylar. Pdf humeral supracondylar fractures are the second most common fractures seen in children and. With the recognised complications of cubitus varus, injury to any of the three. Girls tended to sustain these fractures more often.
Scribd is the worlds largest social reading and publishing site. The specific etiology of supracondylar humerus fractures in children is not well known. Named for the location of this particular break, a supracondylar fracture occurs just above the epicondyles of the humerus. Supracondylar fractures of the humerus sciencedirect.
Patients with supracondylar fractures will often have prolonged period months of inability to fully extend their elbow. Supracondylar fractures of the humerus lww journals wolters. Associated injuries 5% have associated distal radius fracture physical exam of distal forearm radiographs if needed if displaced pin radius also supracondylar. Anatomy of the distal humerus includes medial and lateral columns. Proper care requires appropriate assessment and prompt orthopedic care for those patients whose fractures pose the greatest risk. Patterns of pediatric supracondylar humerus fractures. All supracondylar humerus fractures treated at childrens hospital and health center, san diego chsd over.
Surgical treatment of displaced supracondylar pediatric humerus. The humerus hu mer us bone is the long, thick bone in the upper arm that extends from the shoulder to the elbow. According to an epidemiological study, the incidence of fracture supracondylar humerus is 30800 per year in the general population. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. A particular subset of pediatric extremity vascular injuries is the pink pulseless hands associated with supracondylar humerus fractures. Supracondylar fracture of humerus in children free download as powerpoint presentation. Complications of supracondylar fractures of the elbow. It has been estimated that they account for approximately 65% of all fractures and dislocations in children. Supracondylar humerus fractures schf are common injury in children and represent the most frequent fractures involving the elbow 1,2,3. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. Of the 97 supracondylar fractures in this study, 55 56. Humeral supracondylar fracture an overview sciencedirect topics. Supracondylar fracture definition of supracondylar.
Management of supracondylar fractures of the humerus in children. Studies have shown that these fractures occur commonly in children aged between 510 years and up to. This is the most common upper extremity fracture pattern in younger children, and. Raise the arm on a pillow when sitting or lying down loose fitting clothing, not through the sleeve. Supracondylar fractures are the most common pediatric elbow fracture and carry significant potential for neurovascular compromise. The outcome of the operation was independent of the time interval between the trauma and the operation as well as the mode of transportation p 0. She is neurovascularly intact and the skin shows no evidence of open wounds. A supracondylar fracture is a type of bone fracture that afflicts the humerus in the upper arm. These fractures of the distal humerus are frequently problematic in terms of diagnosis, treatment, and complications. The backslab and sling should be placed under figure 2. Supracondylar fractures of the humerus in children vumedi. Subtle signs on plain film radiograph for a supracondylar fracture include. Supracondylar humerus fractures shf comprise 17% of all pediatric fractures and are second in frequency to forearm fractures. Supracondylar humerus fractures in children vumedi.
Management of supracondylar fracture of humerus with jess in adults. Supracondylar humerus fractures are the most common type of elbow fracture in children. This does not cause functional disability and should not be treated with physiotherapy. Supracondylar humerus fracture nationwide childrens. With the recognised complications of cubitus varus, injury to any of the three major nerves around the elbow, absent radial pulse after fracture reduction, stiffness and the fortunately rare incidence of volkmanns ischaemic contracture, an appropriate understanding of the pathology and management of this. A supracondylar humerus sch fracture is the most common type of elbow fracture in children. About 10% to 20% of displaced supracondylar fractures. Supracondylar fractures of the distal humerus are a commonly encountered injury in children. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Temporal characteristics of paediatric supracondylar humerus. Pdf supracondylar fracture of the humerus in children. Supracondylar humeral fractures during childhood1, 2 account for 50% to 60% of the lesions. The perfused, pulseless supracondylar humerus fracture is urgent and ideally goes to the operating room immediately or within a few hours of presentation. Fracture that involves the epiphyseal plate or growth plate of a bone type i.
The supporting evidence is lacking and requires the work group to make a recommendation based on expert opinion by considering the known potential harm and benefits associated with the treatment. Gartlands classification of supracondylar fracture of humerus galeazzi fracture a fracture of the radius with dislocation of the distal radioulnar joint colles fracture a distal fracture of the radius with dorsal posterior displacement of the wrist and hand smiths fracture a distal fracture of the. We then discuss the diagnosis of a supracondylar fracture and the treatment of a supracondylar fracture using easy to understand language and if you have an questions, please email us as we are happy to help. An ebook reader can be a software application for use on a computer such as microsofts free reader application, or a booksized computer this is used solely as a reading device such as nuvomedias rocket ebook.
Their purpose is to allow interested readers the ability to inspect all of the information that the aaos treatment of pediatric supracondylar fracture of the humerus guideline work group used to reach all of its decisions, as well as to verify that these decisions are in accord with the best available evidence. There may be a decreased ability to move the arm and the person may present holding their elbow. The epicondyles are the pair of rounded bony prominences found at the lower end of the humerus bone, just above the elbow joint. Overview supracondylar fractures are one of the most common traumatic fractures see in children and most commonly occur in children 57 years of age from a fall on an outstretched hand treatment is usually closed reduction and percutanous pinning crpp, with the urgency depending on whether the hand remains perfused or not. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. Supracondylar fracture fractured humerus physioadvisor. There is an intervening thin area of bone connecting the olecranon fossa and coronoid fossa, which is the location of most supracondylar humerus fractures. It is also the commonest pediatric fracture around the elbow. Supracondylar and lateral condyle fractures of the humerus.
Supracondylar fractures of the humerus in children. Opening a pediatric supracondylar humerus fracture. A supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. This is called a supracondylar supra con dy ler humerus fracture. Objectivesupracondylar humeral fractures are the most common elbow. Article information, pdf download for temporal characteristics of. Pediatric supracondylar humerus fractures guidelines. Supracondylar humerus fractures and brachial artery injuries. This fracture commonly occurs after a fall on an outstretched arm. Pediatric supracondylar fractures of the distal humerus. These are the two guidelines authors found useful in the diagnosis and treatment of supracondylar humerus fractures.
Supracondylar fractures of the humerus in children youtube. Supracondylar humerus fractures pediatric orthopaedic. Anterior humeral line should intersect with middle third of capitellum see pediatric elbow alignment if not, consider supracondylar fracture or lateral condyle fracture. Gartlands classification of supracondylar fracture of humerus. One from the royal childrens hospital in melbourne australia, and one published on the american academy of orthopaedic surgeons guidelines. Supracondylar fractures of the humerus are a common pediatric elbow injury that can be associated with neurovascular complications and skeletal deformity. Please feel free to give your child some pain medication before.
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