Supracondylar fractures in children

Key points

1. The commonest elbow fracture in children, usually after a fall on an outstretched hand.
2. Extension-type fractures make up about 95%.
3. Gartland classification: I undisplaced, II hinged with an intact posterior cortex, III completely displaced.
4. Check the radial pulse, perfusion of the hand, and the anterior interosseous, median, radial and ulnar nerves.
5. Displaced fractures are usually treated with closed reduction and percutaneous pinning.

Image guide

What to look for in each view of this topic.

1. Anterior humeral line. Should pass through the middle third of the capitellum; it passes anteriorly in extension-type fractures.
2. Posterior fat pad. A visible posterior fat pad indicates an effusion and an occult fracture.
3. Gartland III. Complete displacement with no cortical contact.
4. Lateral pinning. Two or three divergent lateral pins avoid the ulnar nerve.