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Supracondylar Humerus Fracture Flexion Type

  • Oussama Abousamra
  • Christopher Iobst
Living reference work entry

Abstract

An 8-year-old boy sustained an injury to his left elbow while playing on the playground. Left elbow radiographs showed a distal humerus supracondylar fracture with the distal fragment translated anteriorly indicating a flexion-type supracondylar injury. The injury was isolated, and the neurovascular exam (with special attention to the ulnar nerve) was normal. Ulnar nerve palsy can be present in around 10% of flexion-type fractures. The decision was made to proceed with closed reduction and percutaneous pinning. The need for a possible open reduction was discussed with the family since a higher risk for open reduction has been reported with flexion-type fractures. In our case, the fracture was closed reduced with placement of three percutaneous lateral pins. The patient was discharged home later the same day after checking the neurovascular status of his left upper extremity. Radiographic follow-up evaluations were performed at 1 week and 4 weeks postoperatively. Once healing was confirmed, pins were removed and the cast discontinued. At the 8-week clinic visit, he had full range of motion of his left elbow with no malalignment.

References and Suggested Readings

  1. Chukwunyerenwa C, Orlik B, El-Hawary R, Logan K, Howard JJ (2016) Treatment of flexion-type supracondylar fractures in children: the “push-pull” method for closed reduction and percutaneous K-wire fixation. J Pediatr Orthop B 25(5):412–416CrossRefPubMedGoogle Scholar
  2. Combs K, Frick S, Kiebzak G (2016) Multicenter study of pin site infections and skin complications following pinning of pediatric supracondylar humerus fractures. Cureus 8(12):e911PubMedPubMedCentralGoogle Scholar
  3. Flynn K, Shah AS, Brusalis CM, Leddy K, Flynn JM (2017) Flexion-type supracondylar humeral fractures: ulnar nerve injury increases risk of open reduction. J Bone Joint Surg Am 99(17):1485–1487CrossRefPubMedGoogle Scholar
  4. Novais EN, Carry PM, Mark BJ, De S, Miller NH (2016) Posterolaterally displaced and flexion-type supracondylar fractures are associated with a higher risk of open reduction. J Pediatr Orthop B 25(5):406–411CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNationwide Children’s HospitalColumbusUSA
  2. 2.College of Medicine, Orthopaedic SurgeryOhio State UniversityColumbusUSA

Section editors and affiliations

  • Richard Reynolds
    • 1
  1. 1.Nemours PensacolaPensacolaUSA

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