1. SUPRACONDYLAR FRACTURE
BY : DR SANJEEV

2. Fig :
SUPRACONDYLAR FRACTURE

3. Fig :
SUPRACONDYLAR FRACTURE

4. 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

5. 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

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

7. Fig :
Type 2 : displaced but posterior cortex is intact

8. Fig :
Type 3 : SUPRACONDYLAR FRACTURE

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

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

11. 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

12. 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.

13. 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.

14. 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.

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

16. Complication :
Fig :

17. Fig :
SUPRACONDYLAR FRACTURE

18. Fig :
SUPRACONDYLAR FRACTURE

19. Fig :
Type 2 : displaced but posterior cortex is intact

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

21. 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

22. Complication :
Fig :

23. Fig :
SUPRACONDYLAR FRACTURE

24. Fig :
SUPRACONDYLAR FRACTURE