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.

 Baumann`s angle : angle between the

Fig : A P view

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