Supracondylar Fracture

Aetiology

  • One of the most common traumatic fractures see in children, commonly due to a FOOSH

Clinical presentation

Symptoms

  • Pain
  • Refusal to move elbow

Signs

  • Gross deformity, swelling, ecchymosis
  • Limited active elbow motion
  • Neurovascular exam - brachial artery, median nerve

Investigations

  • X-ray - AP and lateral
    • Assess humerocapitellar alignment
    • Posterior fat pad sign - lucency on a lateral view along the posterior distal humerus and olecranon fossa is highly suggestive of occult fracture around the elbow
notion image

Management

  • Conservative - cast
  • Operative - closed/open reduction and percutaneous pinning

Complications

  • Can damage the brachial artery acutely and if untreated will cause malunite, causing lifelong disability
  • Median nerve also at risk of damage