Supracondylar Fracture: Classification, Types,Treatment, Complications

Supracondylar fracture occurs commonly in distal humerus. Children more commonly suffer from this fracture than adults and it may cause serious complications if ignored. Supracondylar fracture commonly occurs because of a fall on outstretched hands.^[1]

• Type 1– Undisplaced or marginal displacement of the bones.
• Type 2– Partially displaced fracture, which results in minor deformity.
• Type 3– Completely displaced fracture with separated bone fragments. It results in a major deformity.

• Falling onto an outstretched hand.
• Direct trauma to the elbow.

• Immediate elbow pain following a trauma or injury to the elbow.
• Tenderness to touch.
• Swelling is present in type 2 and 3 fracture.
• The elbow appears deformed or crooked in type 2 and 3 injuries.
• Worsening pain upon the movement of arm.
• Bruising may be present.
• Numbness, tingling, cold or pale skin is an indication of neural or vascular damage and immediate medical care should be sought.
• In type I injury, there is mild swelling and pain due to which the patient may be unaware of a fracture. Signs to look for are, if the child is finding it difficult to use the elbow or is guarding it.

• X-ray confirms the diagnosis.
• Immobilization with casting for six weeks usually suffices for type 1 fracture.
• Manipulation to realign the bones is required in type 2 fracture, after which, it is immobilized with casting.
• Surgery is needed for type III fracture for realignment of bones and stabilize them by using pins or wires. After the surgery, the arm is immobilized in a splint for some days and then application of cast for immobilization.
• After the fracture has healed, the patient should start a rehab program comprising of stretching and strengthening exercises to regain mobility, flexibility and range of motion of the arm.

• Loss of Range of Motion: In some cases, there is inability to fully straighten elbow.
• Vascular Injury: The brachial artery can be injured as it passes very near to the fractured area. Symptoms to watch out for are cold and pale skin in the hand and widespread bruising.
• Nerve Injury: The median nerve may get damaged as it passes very closely to the fractured area. Symptoms to look out for are numbness, tingling or weakness in the elbow or hand.
• Malunion: This is a condition when the parts of bone do not heal in proper alignment.

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