The Journal of Bone and Joint Surgery (American). 2008;90:1121-1132.
doi:10.2106/JBJS.G.01354
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Current Concepts Review

Supracondylar Humeral Fractures in Children

Reza Omid, MD1, Paul D. Choi, MD1 and David L. Skaggs, MD1

1 Childrens Orthopaedic Center, Childrens Hospital Los Angeles, 4650 Sunset Boulevard, MS 69, Los Angeles, CA 90027
Investigation performed at Childrens Hospital Los Angeles, Los Angeles, California

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Operative fixation is indicated for most type-II and III supracondylar humeral fractures in order to prevent malunion.

Medial comminution is a subtle finding that, if treated nonoperatively, is likely to lead to unacceptable varus malunion.

Angiography is not indicated for a pulseless limb, as it delays fracture reduction, which usually corrects the vascular problem.

A high index of suspicion is necessary to avoid missing an impending compartment syndrome, especially when there is a concomitant forearm fracture or when there is a median nerve injury, which may mask symptoms of compartment syndrome.

Lateral entry pins have been shown, in biomechanical and clinical studies, to be as stable as cross pinning if they are well spaced at the fracture line, and they are not associated with the risk of iatrogenic ulnar nerve injury.


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