The Hip: Preservation, Replacement and Revision

Flexion Type Supracondylar Frx

Discussion:

       - 5-10% of all supracondylar frxs
       - occurs from fall w/ elbow flexed as it hits the ground;
       - posterior cortex fails first;
       - resulting frx has anterior displacement of the distal fragment in sagittal plane, and lateral/valgus displacement in coronal plane
       - fracture line courses from below upward and forward;
       - soft tissue swelling and damage are usually much less than in the extension type and neurovascular complications are rare;
       - ulnar nerve palsy occurs in some cases; injured by the sharp spike of proximal fragment
       - classfication:
                 - can use a similar classification scheme as extension type injury: types I, II, III
                 - type I: undisplaced or minimally displaced, cast/splint
                 - type II:
                       - inegrity of anterior cortex remains, but with anterior displacement of distal fragment
                       - reduce and cast in extension, 
                       - may need pinning
                 - type III: complete displacement, usually requires open reduction and percutaneous pins


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Low incidence of flexion-type supracondylar humerus fractures but high rate of complications

Operative Management of Displaced Flexion Supracondylar Humerus Fractures in Children



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, August 12, 2016 8:28 am