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1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
Fractures result from:
1) Injury;
2) Repetitive stress;or
3) Abnormal weakening of the bone (a ‘pathological’fracture).
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
TYPES OF FRACTURE
COMPLETE FRACTURES
The bone is split into two or more fragments
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
TYPES OF FRACTURE
INCOMPLETE FRACTURES
Here the bone is incompletely divided and the periosteum remains in continuity
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
OSTEOLOGY
3. Mitchelson AJ, Illingworth KD, Robinson BS, et al. Patient demographics and risk factors in pediatric distal humeral supracondylar fractures. Orthopedics.
2013;36(6):e700ee706.
• The annual incidence of supracondylar fractures has been estimated at 177.3
per 100 000
• Some studies indicate a greater risk in boys, but recent data have evidenced
growing injury rates across both sexes possibly due to increased participation
in sports.
• Patients above the age of 8 years→ most often results from high-energy
traumas
• extension type of fracture in 97–99%, flexion type→ rare
4. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg Am 2008; 90:1121–1132.
5. Houshian S, Mehdi B, Larsen MS. The epidemiology of elbow fracture in children: analysis of 355 fractures, with special reference to supracondylar
humerus fractures. J Orthop Sci 2001; 6:312–315.
2. Jon C Thompson (2010). Netter’s concise orthopaedic anatomy 2nd Edition.
CLASSIFICATION
Gartland Classification (Extension type)
6.Choi PD, Melikian R, Skaggs DL. Risk Factors for vascular repair and compartment syndrome in the pulseless supracondylar humerus fracture
in children. J Pediatr Orthop. 2010;30(1):50e56.
7.Skaggs D, Frick S. Upper extremity fractures in children. In:Weinstein SL, Flynn JM, eds. Lovell and Winter’s Pediatric Orthopaedics.7th ed.
Philadelphia, PA: Lippincott Williams & Wilkins;2014: Chapter 33: 1704e1724.
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
TREATMENT
• Type I SCH
fractures can be treated with long arm immobilization for 3 to 4 weeks
• Type II SCH
fractures can be treated with closed reduction and long arm casting in
hyperflexion, or with CRPP
• Type III SCH
fractures should be treated with CRPP
8.Ballal MS, Garg NK, Bass A, Bruce CE. Comparison between collar and cuffs and above elbow back slabs in the initial treatment of
Gartland type I supracondylar humerus fractures. J Pediatr Orthop B.2008;17(2):57e60.
7.Skaggs D, Frick S. Upper extremity fractures in children. In:Weinstein SL, Flynn JM, eds. Lovell and Winter’s Pediatric Orthopaedics.7th ed.
Philadelphia, PA: Lippincott Williams & Wilkins;2014: Chapter 33: 1704e1724.
• AAOS guidelines suggest CRPP as a treatment method for all displaced
SCH fractures
• The guidelines recommend the use of 2 to 3 laterally introduced pins when
performing CRPP
• Two or 3 pins should be introduced from the lateral aspect to avoid injury to
the ulnar nerve.
9.Howard A, Mulpuri K, Abel MF, et al, American Academy of Orthopaedic Surgeons. The treatment of pediatric supracondylar humerus fractures. J Am Acad
Orthop Surg. 2012;20(5):320e327
10.Mulpuri K, Wilkins K. The treatment of displaced supracondylar humerus fractures: evidence-based guideline. J Pediatr Orthop.2012;32
(suppl2):S143eS152.
1. Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System Of Orthopaedic and Fractures; Ninth Edition. London: HodderArnold.
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