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Supracondylar Fracture
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Gartland fracture
            • Definitions

              • Supracondylar fracture: Transverse fracture of distal humeral metadiaphyseal junction with varying degrees of displacement & comminution
              • FOOSH injury: Fall on outstretched hand
              • Anterior humeral line: Vertical line drawn along anterior cortex of humeral diaphysis; normally bisects capitellum
              • Radiocapitellar (RC) line: Line drawn through long axis of radius; normally bisects capitellum on any view
                • Due to eccentric ossification of capitellum, RC line may not bisect ossified capitellum < 10 years of age

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Fader LM et al: Eccentric capitellar ossification limits the utility of the radiocapitellar line in young children. J Pediatr Orthop. 36(2):161-6, 2016
                                      2. Hyatt BT et al: Complications of pediatric elbow fractures. Orthop Clin North Am. 47(2):377-85, 2016
                                      3. Kang S et al: The prognostic value of the fracture level in the treatment of Gartland type III supracondylar humeral fracture in children. Bone Joint J. 97-B(1):134-40, 2015
                                      4. Muchow RD et al: Neurological and vascular injury associated with supracondylar humerus fractures and ipsilateral forearm fractures in children. J Pediatr Orthop. 35(2):121-5, 2015
                                      5. Zorrilla S de Neira J et al: Supracondylar humeral fractures in children: current concepts for management and prognosis. Int Orthop. 39(11):2287-96, 2015
                                      6. Isa AD et al: Functional outcome of supracondylar elbow fractures in children: a 3- to 5-year follow-up. Can J Surg. 57(4):241-6, 2014
                                      7. Ladenhauf HN et al: The displaced supracondylar humerus fracture: indications for surgery and surgical options: a 2014 update. Curr Opin Pediatr. 26(1):64-9, 2014
                                      8. Little KJ: Elbow fractures and dislocations. Orthop Clin North Am. 45(3):327-40, 2014
                                      9. Matuszewski Ł: Evaluation and management of pulseless pink/pale hand syndrome coexisting with supracondylar fractures of the humerus in children. Eur J Orthop Surg Traumatol. 24(8):1401-6, 2014
                                      10. Narayanan S et al: Fishtail deformity - a delayed complication of distal humeral fractures in children. Pediatr Radiol. 45(6):814-9, 2014
                                      11. Pennock AT et al: Potential causes of loss of reduction in supracondylar humerus fractures. J Pediatr Orthop. 34(7):691-7, 2014
                                      12. Valencia M et al: Long-term functional results of neurological complications of pediatric humeral supracondylar fractures. J Pediatr Orthop. 35(6):606-10, 2014
                                      13. Wegmann H et al: The impact of arterial vessel injuries associated with pediatric supracondylar humeral fractures. J Trauma Acute Care Surg. 77(2):381-5, 2014
                                      14. Glotzbecker MP et al: Fishtail deformity of the distal humerus: a report of 15 cases. J Pediatr Orthop. 33(6):592-7, 2013
                                      15. Tomaszewski R et al: Analysis of early vascular and neurological complications of supracondylar humerus fractures in children. Pol Orthop Traumatol. 77:101-4, 2012
                                      16. Pudas T et al: Magnetic resonance imaging in pediatric elbow fractures. Acta Radiol. 46(6):636-44, 2005
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Gartland fracture
                                                • Definitions

                                                  • Supracondylar fracture: Transverse fracture of distal humeral metadiaphyseal junction with varying degrees of displacement & comminution
                                                  • FOOSH injury: Fall on outstretched hand
                                                  • Anterior humeral line: Vertical line drawn along anterior cortex of humeral diaphysis; normally bisects capitellum
                                                  • Radiocapitellar (RC) line: Line drawn through long axis of radius; normally bisects capitellum on any view
                                                    • Due to eccentric ossification of capitellum, RC line may not bisect ossified capitellum < 10 years of age

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Demographics

                                                                    • Natural History & Prognosis

                                                                      • Treatment

                                                                        DIAGNOSTIC CHECKLIST

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Fader LM et al: Eccentric capitellar ossification limits the utility of the radiocapitellar line in young children. J Pediatr Orthop. 36(2):161-6, 2016
                                                                          2. Hyatt BT et al: Complications of pediatric elbow fractures. Orthop Clin North Am. 47(2):377-85, 2016
                                                                          3. Kang S et al: The prognostic value of the fracture level in the treatment of Gartland type III supracondylar humeral fracture in children. Bone Joint J. 97-B(1):134-40, 2015
                                                                          4. Muchow RD et al: Neurological and vascular injury associated with supracondylar humerus fractures and ipsilateral forearm fractures in children. J Pediatr Orthop. 35(2):121-5, 2015
                                                                          5. Zorrilla S de Neira J et al: Supracondylar humeral fractures in children: current concepts for management and prognosis. Int Orthop. 39(11):2287-96, 2015
                                                                          6. Isa AD et al: Functional outcome of supracondylar elbow fractures in children: a 3- to 5-year follow-up. Can J Surg. 57(4):241-6, 2014
                                                                          7. Ladenhauf HN et al: The displaced supracondylar humerus fracture: indications for surgery and surgical options: a 2014 update. Curr Opin Pediatr. 26(1):64-9, 2014
                                                                          8. Little KJ: Elbow fractures and dislocations. Orthop Clin North Am. 45(3):327-40, 2014
                                                                          9. Matuszewski Ł: Evaluation and management of pulseless pink/pale hand syndrome coexisting with supracondylar fractures of the humerus in children. Eur J Orthop Surg Traumatol. 24(8):1401-6, 2014
                                                                          10. Narayanan S et al: Fishtail deformity - a delayed complication of distal humeral fractures in children. Pediatr Radiol. 45(6):814-9, 2014
                                                                          11. Pennock AT et al: Potential causes of loss of reduction in supracondylar humerus fractures. J Pediatr Orthop. 34(7):691-7, 2014
                                                                          12. Valencia M et al: Long-term functional results of neurological complications of pediatric humeral supracondylar fractures. J Pediatr Orthop. 35(6):606-10, 2014
                                                                          13. Wegmann H et al: The impact of arterial vessel injuries associated with pediatric supracondylar humeral fractures. J Trauma Acute Care Surg. 77(2):381-5, 2014
                                                                          14. Glotzbecker MP et al: Fishtail deformity of the distal humerus: a report of 15 cases. J Pediatr Orthop. 33(6):592-7, 2013
                                                                          15. Tomaszewski R et al: Analysis of early vascular and neurological complications of supracondylar humerus fractures in children. Pol Orthop Traumatol. 77:101-4, 2012
                                                                          16. Pudas T et al: Magnetic resonance imaging in pediatric elbow fractures. Acta Radiol. 46(6):636-44, 2005