SUPRACONDYLAR FRACTURE BY DR SANJEEV Fig SUPRACONDYLAR FRACTURE

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

: A P view • Fig 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/ 3 rd of capitulum. if it passes through anterior 1/3 rd , 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 1/3 rd , it indicates poterior displacement of the distal fragment.

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

Complication : • Fig :

Fig : • SUPRACONDYLAR FRACTURE

Fig : • SUPRACONDYLAR FRACTURE