Supracondylar fractures of the humerus occur just above the elbow joint. They are most common in children and usually result from a fall onto an outstretched hand, causing hyperextension of the elbow. There are two main types - extension type fractures tilt the distal fragment backwards while flexion types tilt it forwards. Displacements can include posterior or medial shifting of the fragments. Treatment depends on the degree of displacement and may include closed reduction, percutaneous pinning, or open reduction and internal fixation. Complications can include nerve injuries, vascular injuries, malunion and contracture.

1. SUPRA CONDYLAR FRACTURE

2. DEFINITION
• Supracondylar fracture of the humerus is one which
occurs in the distal third of the bone
• Fracture line lies proximal to the lower end of humerus
• Comprises of
• Trochlea and capitulum
• May passes through
• Apice of coronoid and olecreanon fossae

3. MECHANISM
• Fall on an out stretched hand
• Hyperextension fracture of distal end- above
condyles
• Common in pediatric age group
• Fracture line usually transverse

4. TYPES
Extension
Flexion

6. • Less common 1%
• Tilted forwards
• Flexion of distal fragments
relation to proximal fragment
• Pushed upwards and
forwards
• Common type 99%
• Tilted backwards
• Extension of the distal
fragment of humerus relation
to proximal fragment
• Pushed backwards and
upwards
• Backward angulation
• Twisted inwards
• Slight shift to either on rigt or
left
TYPES
Extension Flexion

7. DISPLACEMENTS
• Posterior or backward shift
• Posterior or backward tilt
• Proximal shift
• Medial or lateral shift
• Medial tilt &internal rotation
Distal
fragments
may
displaced
to

8. PRESENTING COMPLAINTS
History of
Trauma
Pain
Swelling deformity inability to move
affected elbow

9. CLINICAL FEATURES
• Patient hold the elbow in a flexed position by holding
the forearm with other elbow
• Swelling
• Tense ,filling up the hollow around the elbow and
obscuring bony points
• Displaced backward upward medially
• Movements restricted and painful

10. EXAMINATION
• Posterior prominence of elbow joint
• Equilateral triangular relationship of
OLECRANON
MEDIAL LATERAL
• Careful palpation elicit tenderness –distal humerus
• Restricted movements

11. • RADIAL & ULNAR PULSE
• Median nerve
• Radial nerve

12. RADIOLOGICAL EXAMINATION
• AP view
fracture line run transversely above condyles
distal fragment – dispaced & rotated laterally.
• LATERAL view
line runs upwards
& backwards

13. GARTLAND CLASSIFICATION
TYPE I undisplaced
TYPE II partially displaced,
posterior cortex intact
TYPE III complete displacement

14. TREATMENT
• Undisplaced fracture
immobilisation + posterior elbow slab, elbow in 90o flexion
• Displaced fracture
1. closed reduction & percutaneous K wire fixation
2. continuous traction -SMITH’S, DUNLOP’S
3. open reduction & K wire.

15. BAUMANN’S ANGLE
 intersection of a line drawn perpendicular to the
humeral axis and line drawn along the growth plate of
the lateral condyle of the elbow.

16. COMPLICATIONS
IMMEDIATE
Injury to brachial artery, nerves.
EARLY
volkmann’s ischaemia
LATE
1. malunion- cubitus varus or gun stock deformity
2. myositis ossificans
3. volkmann’s ischaemic contracture.

17. THANK YOU