2 - Supracondylar Humerus Fractures

Abstract

Supracondylar humerus (SCH) fractures are common injuries that account for 15% of all pediatric fractures. These injuries most often occur in children 5 to 7 years of age. A thorough preoperative examination is of utmost importance and can help guide the urgency of surgery. Plain x-rays of the injured extremity are typically adequate for evaluating the fracture, and advanced imaging is rarely indicated. The modified Gartland classification system is a commonly used system for evaluation and management of SCH fractures. Closed reduction and percutaneous pinning remains the gold standard for surgical management of displaced SCH fractures, while nondisplaced fractures can be managed nonoperatively with casting and close follow-up. Our understanding of the anatomy and surgical management of SCH fractures has improved. However, it is imperative that the providing orthopedic surgeon be aware of complications that can arise throughout the perioperative course. A few of the common major complications include traumatic and iatrogenic nerve and vascular injuries and postoperative malunion. Compartment syndrome and its sequelae is a relatively rare but devastating complication of SCH fractures. Appropriate identification, assessment, and management of SCH fractures and any associated injuries will help optimize patient outcomes.