Supracondylar Fracture

Supracondylar fractureA Supracondylar Fracture is a break to the lower part of the Humerus (upper arm bone), just above the elbow. It is most common in children. This injury most often occurs following a fall onto an outstretched hand, where the elbow is forced straight.

Supracondylar fracture symptoms

Symptoms of a supracondylar fracture include sudden onset of pain in the elbow following a traumatic incident or accident. Depending on severity of the Supracondylar facture they are graded 1,2 or 3. There well be swelling especially in a type 2 or 3 injury and the elbow is likely to appear deformed.

Pain will be worse when trying to move the arm upwards. Look out for neural or vascular symptoms such as numbness, tingling or cold, pale skin. In type 1 injuries, it may not be clear that there is a fracture present due to mild swelling and pain. Watch out for a child guarding and not using the elbow.

Classifications

A supracondylar fracture can be classified as follows:

  • Type 1 - None of the bones will be displaced. Bones in the arm will be aligned and no deformity will be visible.
  • Type 2 - Is a partially displaced bone with fragments moved partially resulting in minor deformity
  • Type 3 - Fully displaced fracture with bones fragmented and completely separated resulting in major deformity.

Supracondylar fracture treatment

Treatment depends on the level of displacement:

  • Type 1 require simple immobilisation in a cast for 4-6 weeks.
  • Type 2 may require manipulation first to realign the bone sections, before being immobilised in a cast as above.
  • Type 3 requires surgery to realign the bones and hold them in place with pins or wires, before immobilisation in a splint for the first few days and then a cast.

Supracondylar fracture complications

There are a number of complications which may occur following a supracondylar fracture. These become more likely as the severity increases.

  • Loss of movement - many patients lose the ability to completely straighten the elbow.
  • Vascular injuries - the brachial artery runs very close to the fracture area and so may be damaged. Symptoms such as cold, clammy, pale skin in the forearm or hand, or extensive bruising at the elbow may indicate this.
  • Nerve injury - the median nerve runs very close to the fracture area and so may be damaged. Watch out for symptoms such as numbness, tingling or weakness in the elbow, forearm or hand.
  • Mal union - the two parts of bone do not heal in line.