Pediatric Supracondylar Humerus Fractures Guidelines

Updated: Aug 27, 2018
  • Author: Jiun-Lih Jerry Lin, MBBS, MS(Orth); Chief Editor: Jeffrey D Thomson, MD  more...
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Guidelines

Guidelines Summary

Practice Guidelines 

  • Paediatric Supracondylar Humerus fractures are common and significant injuries
  • Serious complications include neurovascular injury, compartment syndrome, malunion and Volkmann contracture
  • Timely diagnosis and proper management can prevent post-injury complications 
  • Diagnosed by AP and true lateral x-rays 
  • Lateral condyle fractures are a differential for supracondylar humerus fractures 
  • Type 1 & 2A fractures may be safely treated non-operatively with compliant patients and parents
  • Type 2B, Type 3 and Flexion type fractures require closed +/- open reduction and percutaneous pin fixation
  • Pulseless and ischaemic limbs require emergency reduction and fixation +/- vascular exploration with vascular surgeons
  • The duration of immobilisation depends on injury severity, age of patient and local hospital protocols
  • Paediatric supracondylar fractures are distinctly different injuries to the adult supracondylar humerus fractures 

These are the two guidelines authors found useful in the diagnosis and treatment of supracondylar humerus fractures. One from the Royal Children’s Hospital in Melbourne Australia, and one published on the American Academy of Orthopaedic Surgeons Guidelines.

  1. Royal Children's Hospital Guideline - Melbourne, Australia [18] http://www.rch.org.au/clinicalguide/guideline_index/fractures/Supracondylar_fracture_of_the_humerus_Outpatient_fracture_clinics/

  2. American Academy of Orthopaedic Surgeons Guideline [19] https://www.aaos.org/research/guidelines/SupracondylarFracture/Summary_of_Recs.pdf