SUPRACONDYLAR FRACTURE BY : DR SANJEEV

Fig : SUPRACONDYLAR FRACTURE

Fig : SUPRACONDYLAR FRACTURE

Supracondylar fracture (Malgaigne`s fracture) Mechanism of injury : Fall on an outstretched hand with hyperextension at the elbow with abduction or adduction , with hand dorsiflexed

Classification Flexion type (2.3 %) Extension type (97.3 %) : -displaced and undisplaced. Clinical features : Pain and swelling – gross S –shaped deformity of the upper arm is obvious Loss of both passive and active movements of the elbow pseudoparalysis

Gartlands classification (in children) Type 1 :undisplaced Type 2 :displaced , but posterior cortex is intact Type 3 : displaced , but no intact posterior cortex.

Fig : Type 2 : displaced but posterior cortex is intact

Fig : Type 3 : SUPRACONDYLAR FRACTURE

Clinical signs : Arm is short , forearm is normal in length Gross swelling , and tenderness Crepitus – present S – shaped deformity Dimple sign

Radiology X- ray of the elbow : A P view Lateral view

Fig : A P view Baumann`s angle : angle between the horizontal line of the elbow and the line drawn through the lateral epiphysis and the long axsis of the arm.(normally less than 5 degree

Cont.. Angle between the long axis of humerus and the transverse of the elbow is normally 90 degree - less than 90 degree suggest cubitus valgus - greater than 90 degree suggests cubitus varus.

Fig :lateral view Anterior humeral line:a line drawn along the anterior border or distal humeral shaft passes through the middle 1/ 3rd of capitulum. if it passes through anterior 1/3rd , it indicates posterior displacement of the distal fragment.

MANAGEMENT Undisplaced fracture :- - POP slab for 3 weeks with elbow in flexion Displaced fracture : Closed reduction Traction Open reduction Elbow is immobilised at least for 3 weeks Pins or casts are removed after 3 weeks Active exercise.

Complication Neurological : Radial nerve (commonly ) Median nerve Ulnar nerve Vascular : Brachial artery Cosmetic abnormalities: Cubitus varus (gunstock elbow)

Complication : Fig :

Fig : SUPRACONDYLAR FRACTURE

Fig : SUPRACONDYLAR FRACTURE

Fig : Type 2 : displaced but posterior cortex is intact

Fig : Anterior humeral line: if it passes through anterior 1/3rd , it indicates poterior displacement of the distal fragment.

Fig : A P view Baumann`s angle : angle between the horizontal line of the elbow and the line drawn through the lateral epiphysis and the long axsis of the arm.(normally less than 5 degree

Complication : Fig :

Fig : SUPRACONDYLAR FRACTURE

Fig : SUPRACONDYLAR FRACTURE