Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children

Soon Chul Lee; Jong Sup Shim

doi:10.12671/jkfs.2012.25.1.82

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Lee and Shim: Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children

Review Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(1): 82-93.

Published online: 31 January 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.1.82

Recent Trends in Treatment of Supracondylar Fracture of Distal Humerus in Children

Soon Chul Lee, M.D., Jong Sup Shim, M.D.

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to: Jong Sup Shim, M.D. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-2991, Fax: 82-2-2-3410-0061, jss3505@skku.edu

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Fig. 1

Various techniques of pin fixation.

(A) Three lateral pains (AP and Lat view).

(B) Crossed and divergent three pins (AP and Lat view).

(C) Crossed two pains (AP and Lat view).

(D) Divergent two pins (AP and Lat view).

Fig. 2

The medical photo which was taken immediately after operation shows the pin is exposed.

Fig. 3

Pucker sign, one of the spikes from the proximal fragment penetrates the dermal layer. This "pucker sign" is an alert to the fact that the fracture may be difficult to reduce by closed manipulation or traction46).

Fig. 4

(A) At postoperative 3 months, plain radiograph of the elbow joint showed myositis ossificans, (B) which resolved spontaneously after 1 year.

Fig. 5

Undisplaced supracondylar fracture of distal humerus, Gartland type 1a shows the posterior fat pad sign (AP and Lat view).

Fig. 6

In Gartland type 1b, supracondylar fracture of distal humerus, medial cortex is impacted and treated operatively.

(A) Preoperative AP view, (B) Preoperative Lat view, (C) Postoperative AP view, (D) Postoperative Lat view.

Fig. 7

Gartland type 2, supracondylar fracture of distal humerus has the intact posterior cortex (AP and Lat view).

Fig. 8

Completely displaced Gartland type 3, supracondylar fracture of distal humerus treated with closed reduction and percutaneous pinning.

(A) Preoperative AP view, (B) Preoperative Lat view, (C) Postoperative AP view, (D) Postoperative Lat view.

Fig. 9

Flexion type, supracondylar fracture of distal humerus treated with open reduction and pinning.

(A) Preoperative AP and Lat view, (B) Postoperative AP and Lat view.

Fig. 10

CT angiogram of 5 year-old aged boy of left supracondylar fracture. The contrast media doesn't pass the left brachial artery (Arrow).

Fig. 11

Volkmann's ischemic contracture.

(A) 5 days after supracondylar fracture compartment syndrome is developed.

(B) Volkmann's ischemic contracture

Fig. 12

Cubitus varus.

(A) The 6 year-old aged patient who suffered supracondylar fracture of distal humerus was treated with closed reduction and percutaneous pinning. Immediate postoperative plain radiogram shows the coronal tilting and extension deformity (AP and Lat view).

(B) He developed cubitus varus. (Left) Medical photo. (Right) Plain radiopraphy of both elbow AP view.

(C) Corrective osteotomy with using lateral closing wedge osteotomy is performed.

(D) Immediate postop plain radiography shows the prominence of lateral condyle of distal humerus.

(E) At postoperative 3 years, the lateral prominence is decreased by remodeling.

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