Supracondylar humerus fracture

Abstract

Supracondylar humerus fractures are the most common elbow fractures in children. While nondisplaced type I supracondylar fractures can be managed nonoperatively with reduction and casting, operative fixation with closed reduction and percutaneous pinning (CRPP) is indicated for most displaced injuries (Types II, III, and IV). Two or three lateral pins are usually sufficient to stabilize most fractures; however, in very rare cases of persistent instability after third lateral pin, a medial pin may be required. Consideration of management of supracondylar humerus injuries should include a thorough evaluation of limb perfusion as this has consequences for treatment. Limbs that regain perfusion but remain pulseless after operative fixation can be observed for an additional 48 h. But limbs that remain poorly perfused require urgent open exploration. Surgicalmanagement of supracondylar humerus fractures has good outcomes and very low complication rates.