![]() Neural injuries occur in 6.5% to 19% of cases involving displaced fractures. In most cases, fracture reduction restores perfusion. Lateral entry pins provide stable fixation, avoiding the risk of iatrogenic ulnar nerve injury.Ībout 10% to 20% of displaced supracondylar fractures present with alterations in vascular status. Open reduction via the anterior approach is indicated for open fractures, absence of the distal vascular flow for > 10 to 15 minutes after closed reduction, and failed closed reduction. Type IV fractures can only be diagnosed intra-operatively.Ĭlosed reduction and percutaneous pinning is the gold standard surgical treatment. ![]() Surgical treatment is the standard for almost all displaced fractures. Gartland’s classification shows high intra- and inter-observer reliability. Compartment syndrome should always be borne in mind, especially when skin puckering, severe ecchymosis/swelling, vascular alterations or concomitant forearm fractures are present. To manage the vascular status, distal pulse and hand perfusion should be monitored. Flexion-type fractures are more commonly associated with ulnar nerve injuries.Ĭoncomitant upper-limb fractures should always be excluded. Posteromedial displacement of the distal fragment is the most frequent however, the radial and median nerves are equally affected. Supracondylar fractures of the humerus are the most frequent fractures of the paediatric elbow, with a peak incidence at the ages of five to eight years.Įxtension-type fractures represent 97% to 99% of cases. ![]()
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