Supracondylar fracture - Revision history

Rossdonaldson1: /* Evaluation */

2023-05-10T17:36:16Z

Evaluation

← Revisión anterior		Revisión del 17:36 10 may 2023
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	===Imaging===		===Imaging===
	*[[Elbow X-ray (Peds)\|True lateral elbow]]		*[[Elbow X-ray (Peds)\|True lateral elbow]]
	[[File:Supracondylar09.jpg\|thumb]]		[[File:Supracondylar09.jpg\|thumb\|Supracondylar fracture]]
	**Anterior humeral line should intersect with middle third of capitellum (see pediatric elbow alignment)		**Anterior humeral line should intersect with middle third of capitellum (see pediatric elbow alignment)
	***If not, consider supracondylar fracture (or lateral condyle fracture)		***If not, consider supracondylar fracture (or lateral condyle fracture)

Rossdonaldson1: /* Imaging */

2019-09-18T07:14:06Z

Imaging

← Revisión anterior		Revisión del 07:14 18 sep 2019
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	===Imaging===		===Imaging===
	*[[Elbow X-ray (Peds)\|True lateral elbow]]		*[[Elbow X-ray (Peds)\|True lateral elbow]]
			[[File:Supracondylar09.jpg\|thumb]]
	**Anterior humeral line should intersect with middle third of capitellum (see pediatric elbow alignment)		**Anterior humeral line should intersect with middle third of capitellum (see pediatric elbow alignment)
	***If not, consider supracondylar fracture (or lateral condyle fracture)		***If not, consider supracondylar fracture (or lateral condyle fracture)

Rossdonaldson1 at 07:05, 18 September 2019

2019-09-18T07:05:07Z

← Revisión anterior		Revisión del 07:05 18 sep 2019
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			''This page is for <u>pediatric</u> patients; for adult patients see [[distal humerus fracture]]''
	==Background==		==Background==
	*Most common elbow fracture in patients age <8yr		*Most common elbow fracture in patients age <8yr

Rossdonaldson1: /* Specific Management */

2019-09-18T03:02:07Z

Specific Management

← Revisión anterior		Revisión del 03:02 18 sep 2019
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	===Specific Management===		===Specific Management===
	*Immobilize using double sugar tong or long-arm posterior splint		*Immobilize using double sugar tong or long-arm posterior splint
	**Elbow at ~~90degrees~~, forearm in pronation or neutral rotation		**Elbow at 90 degrees, forearm in pronation or neutral rotation
	*Types II & III should have orthopedic consult in the ED		*Types II & III should have orthopedic consult in the ED

Rossdonaldson1: /* Management */

2019-09-18T03:01:58Z

Management

← Revisión anterior		Revisión del 03:01 18 sep 2019
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	==Management==		==Management==
			{{General Fracture Management}}

			===Specific Management===
	*Immobilize using double sugar tong or long-arm posterior splint		*Immobilize using double sugar tong or long-arm posterior splint
	**Elbow at 90degrees, forearm in pronation or neutral rotation		**Elbow at 90degrees, forearm in pronation or neutral rotation

Ostermayer: /* Evaluation */

2019-05-29T18:21:35Z

Evaluation

← Revisión anterior		Revisión del 18:21 29 may 2019
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	[[File:Elbowalignment.png\|thumb\|Normal pediatric elbow alignment]]		[[File:Elbowalignment.png\|thumb\|Normal pediatric elbow alignment]]
	[[File:Elbow ant fat pad.jpg\|thumb\|Anterior "Sail sign"]]		[[File:Elbow ant fat pad.jpg\|thumb\|Anterior "Sail sign"]]
			*Lateral and AP radiographs are usually sufficient, and in many instances demonstrate an obvious fracture. Often, however, no fracture line can be identified. In such cases assessing for indirect signs is essential:
			**'''Anterior fat pad sign''' (sail sign): the anterior fat pad is elevated by a joint effusion and appears as a lucent triangle on the lateral projection
			**'''Posterior fat pad sign'''
			**'''Anterior humeral line''' should intersect the middle third of the capitellum in most children although, in children under 4, the anterior humeral line may pass through the anterior third without injury

	===Imaging===		===Imaging===

Mholtz at 06:20, 17 June 2018

2018-06-17T06:20:19Z

← Revisión anterior		Revisión del 06:20 17 jun 2018
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	**Complete periosteal disruption with instability in flexion and extension		**Complete periosteal disruption with instability in flexion and extension

	==Management ~~& Disposition~~==		==Management==
	*Type I		*Immobilize using double sugar tong or long-arm posterior splint
	**Immobilize using double sugar tong or long-arm posterior splint ~~x3wk~~		**Elbow at 90degrees, forearm in pronation or neutral rotation
	***Elbow at 90degrees, forearm in pronation or neutral rotation		*Types II & III should have orthopedic consult in the ED
	**Refer to ortho within 48hr
	*Types II & III		==Disposition==
	**Orthopedic consult in the ED		*Type I fractures may be discharged with ortho follow-up in 48 hours
	**~~Admit~~		*Type II and III fractures generally require admission

	==Complications==		==Complications==
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	*Volkmann Ischemic Contracture ([[Compartment syndrome\|Compartment Syndrome]] of forearm)		*Volkmann Ischemic Contracture ([[Compartment syndrome\|Compartment Syndrome]] of forearm)
	**Occurs more commonly when forearm is also fractured		**Occurs more commonly when forearm is also fractured
	**Mere lack of a radial pulse does not indicate ischemia unless accompanied by:		**Mere lack of a radial pulse does not indicate ischemia unless accompanied by: refusal to open hand, pain with passive extension of fingers, or forearm tendernes
	***Refusal to open hand		*Brachial artery injury - suggested by ecchymosis over anteromedial aspect of forearm
	***Pain with passive extension of fingers
	***Forearm tendernes
	*Brachial artery injury
	**Suggested by ecchymosis over anteromedial aspect of forearm
	**Strong collaterals might mask vascular injury		**Strong collaterals might mask vascular injury

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	==References==		==References==
	<references/>		<references/>
	*http://www.orthobullets.com
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:Orthopedics]]		[[Category:Orthopedics]]

Aganapathy: /* Neurologic */

2018-01-28T09:55:27Z

Neurologic

← Revisión anterior		Revisión del 09:55 28 ene 2018
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	===Neurologic===		===Neurologic===
	*Majority of nerve injuries are neuropraxias without long-term sequelae		*Majority of nerve injuries are neuropraxias without long-term sequelae
	*Median nerve injury		*Median nerve injury (typically AIN)
	**Motor: Weakness of hand flexors (difficulty making "OK" sign), abduction of thumb		**Motor: Weakness of hand flexors (difficulty making "OK" sign), abduction of thumb
	**Sensory: Altered two-point sensation on palmar surface of thumb, IF, MF		**Sensory: Altered two-point sensation on palmar surface of thumb, IF, MF

Ravillaa: /* Gartland Classification */

2017-08-08T15:00:52Z

Gartland Classification

← Revisión anterior		Revisión del 15:00 8 ago 2017
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	***If distal fragment is posteromedially displaced: radial nerve injury		***If distal fragment is posteromedially displaced: radial nerve injury
	***If distal fragment is posterolaterally displaced: median nerve, brachial artery injury		***If distal fragment is posterolaterally displaced: median nerve, brachial artery injury
			*Type IV
			**Complete periosteal disruption with instability in flexion and extension

	==Management & Disposition==		==Management & Disposition==

Josgood: /* Vascular */

2017-04-21T00:45:32Z

Vascular

← Revisión anterior		Revisión del 00:45 21 abr 2017
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	==Complications==		==Complications==
	===Vascular===		===Vascular===
	*Volkmann Ischemic Contracture (Compartment Syndrome of forearm)		*Volkmann Ischemic Contracture ([[Compartment syndrome\|Compartment Syndrome]] of forearm)
	**Occurs more commonly when forearm is also fractured		**Occurs more commonly when forearm is also fractured
	**Mere lack of a radial pulse does not indicate ischemia unless accompanied by:		**Mere lack of a radial pulse does not indicate ischemia unless accompanied by: