The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles. Dunlops traction supracondylar and trans condylar fractures in children used when closed reduction difficult or traumatic forearm skin traction with weight on upper arm elbow flexed 45 degrees. A retrospective comparative study was done of two groups of patients with displaced supracondylar fractures of the humerus. Aug 23, 2019 distal humerus fractures in adults are relatively uncommon injuries, representing only about 3% of all fractures in adults. Sep 07, 2012 gartland classification of supracondylar fractures.
Supracondylar fractures in children final authorstream. Baumann 1929 recommended traction in severely displaced cases, especially if the patients came for treatment late. Supracondylar fractures constitutes approximately 50% of all fractures. This clinical pathway aims to assist ed physicians, gps and orthopaedic surgeons manage pediatric supracondylar humerus fractures that present acutely. I have a minor complaint, however, concerning an article in the journal, feb. Full text is available as a scanned copy of the original print version. Straight lateral traction in selected supracondylar. Supracondylar humerus fracture what is a supracondylar fracture. The aim of this study was to compare the outcomes of supracondylar fractures. This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture. Supracondylar fractures of the humerus represent a significant burden of injuries in children, accounting for 1217% of all paediatric fractures 2.
Percutaneous pinning of supracondylar fractures of the. Most common fracture around the elbow in children 60 percent of elbow fractures peak age between 5 and 7 years boys had a higher incidence at the peak age for supracondylar fractures, there is a naturally occurring hyperextension of the elbow, which predisposes the distal humerus to this type of fracture. Displaced supracondylar fractures of the humerus in children. Lateral traction, the other type commonly used for these injuries originally described by dunlop le, was used by us on only one occasion. Supracondylar fractures are the most common type of upper arm injury in children. A, an anteriorposterior view shows a fairly subtle lucency through the distal humerus. Raise the arm on a pillow when sitting or lying down loose fitting clothing, not through the sleeve.
Supracondylar fractures are very common in children and account for about 60% of all paediatric elbow fractures. Supracondylar fractures in children final authorstream presentation. The association with neurovascular compromise and the potential problems of accurately reducing a displaced fracture. It is widely used for femoral fractures, low back pain, acetabular fractures and hip fractures. Severe lower back pain with lumbosacral radiculopaty antalgic posture first adjustment duration. Sorry, we are unable to provide the full text but you may find it at the following locations. Elevated, straightarm traction for supracondylar fractures of the. Pediatric supracondylar fractures are one of the most common traumatic fractures see in children and most commonly occur in children 57 years of age, usually from a fall on an outstretched hand. Stable fractures dont cause spinal deformity or neurologic deficit. Supracondylar fractures are the most common elbow fracture in children, especially in the first decade of life. May 05, 2014 supracondylar fractures in children 1.
Supracondylar fractures of the humerus request pdf. Posteromedia l vs posterolateral biceps tendon insertion and axis of muscle pull lies medial to the shaft of the humerus during fall onto an outstretched supinated arm, the forces applied tend to disrupt the posteromedial periosteum first and displace the fragment posterolaterally. Supracondylar fracture of the humerus is one of the com. Gartlands classification of supracondylar fracture of humerus galeazzi fracture a fracture of the radius with dislocation of the distal radioulnar joint colles fracture a distal fracture of the radius with dorsal posterior displacement of the wrist and hand smiths fracture a distal fracture. Patients and methods from 1977 to1983, 232children with supracondylar fractures ofthehumerus were treated either attheroyal belfast hospital forsickchildren oratthe ulster hospital, dundonald, belfast. Get a printable copy pdf file of the complete article 989k.
Dec 18, 2017 a supracondylar fracture is an injury to the humerus, or upper arm bone, at its narrowest point, just above the elbow. New york, new york 0 ur experience with the socalled lateral traction for the treatment of transcondylar or dicondylar fractures of the humerus in children, dates from the early part of 1939 fig. Seventy patients who had sustained supracondylar fractures of the humerus as children were examined. Used in management of supracondylar and transcondylar fractures. Skin traction rarely causes fracture reduction, but reduces pain and maintains the length of the bone. If you continue browsing the site, you agree to the use of cookies on this website. For many years, surgeons have been using the dunlop traction or cast immobilization after closed manipulative reduction but studies show that these are associated with complications of malunion producing varus and valgus deformities. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint.
Deformity and functional outcome after treatment for. Get a printable copy pdf file of the complete article 989k, or click on a page image below to browse page by page. Congratulations on the modifications of the journal since your editorship began. Dunlop traction in supracondylar fractures of the humerus. Fractures that remain stable after reduction can be. He attends the local emergency department and is informed that he has a supracondylar fracture of his humerus. Jefferiss princess elizabeth orthopaedic hospital, exeter summary a method of treating completely displaced supra condylar fractures of the humerus in children by traight lateral traction as originally used by john dunlop, is recommended. With the recognised complications of cubitus varus, injury to any of the three major nerves around the. Displaced supracondylar fractures of the humerus in childrentreatment by dunlops traction. Presentation of supracondylar fractures of the humerus in singapore children wcgpeh s r e sayampanathan.
This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Supracondylar humeral fracture radiology reference article. Pdf deformity and functional outcome after treatment for. Gartlands classification of supracondylar fracture of humerus. Elevated, straightarm traction for supracondylar fractures. Skin traction is applied according to dunlop s original description, that is,with the elbow extended inthestraight lateral position dunlop. Dunlop s traction as used in this series has been so consistently satisfactory that it is used for all moderately to severely displaced supracondylar fractures of the humerus in children treated at the. Injury, 8, 2220 printed in great britain 2 traight lateral tractionin selected supracondylar fractures of the humerus in children christopher d. Oct 01, 2010 deformity and functional outcome after treatment for supracondylar humerus fractures in children. Seventynine of these patients were treated by dunlops traction and were. Outcome of displaced supracondylar fractures in children. Supracondylar fractures of the humerus were treated in 50 children over a sixyear period. Full text full text is available as a scanned copy of the original print version.
Skintractiontreatment of supracondylar fractures of the humerus. The reported incidence of each of these injuries and the occasional combination injury varies 47,10,11,16,19,20,22,23,24,25 and may reflect small numbers of patients in some series, inclusion of all types of supracondylar fractures. The supracondylar fracture of the humerus is the mostcommon and the likely, when badly displaced, to be accompanied by vascular injury. Skin traction is placed on the forearm and a special frame used on the side of the bed. Dunlop s traction as used in this series has been so consistently satisfactory that it is used for all moderately to severely displaced supracondylar fractures of the humerus in children treated at the naval hospital.
Supracondylar humerus fractures supracondylar humerus fractures flexion typeflexion type rare, only 2%rare, only 2% distal fracture fragmentdistal fracture. New york, new york 0 ur experience with the socalled lateral traction for the treatment of transcondylar or dicondylar fractures. The inclusion criteria were open humeral growth plate and grade ii and iii displaced fractures. Skin traction applied to the skin with adhesive material or straps foam boots and the skin serve as the counterpull. The backslab and sling should be placed under figure 2.
Neurovascular injuries in type iii humeral supracondylar. In a study of 4536 consecutive fractures in adults seen in the massachusetts general hospital emergency department, only 0. Treatment of supracondylar fracture of the humerus by skeletal traction in an abduction splint. Fixation of supracondylar humeral fracture in children by. The patients in the first group were treated with dunlop s traction, while those in the second group were treated by percutaneous pin fixation. This does not cause functional disability and should not be treated with physiotherapy. Traction summary supracondylar fractures of the humerus are one of the most common fractures of childhood. Sickkids parent information sheet supracondylar humerus fracture. Request pdf supracondylar fractures of the humerus supracondylar fractures of the humerus are one of the most common fractures of childhood. Supracondylar humeral fracture radiology reference. Epidemiology simple supracondylar fractures are typically seen in yo.
Pdf supracondylar fractures of the humerus in children. Extension injuries account for 95% of supracondylar fractures. Dunlop traction ide arm skin traction dunlop traction ooverheadverhead sskeletal tractionkeletal traction. Transcondylar fractures of the humerus treated by dunlop. Supracondylar fractures of the humerus are one of the most common fractures of childhood. The main use of dunlop s traction is in the maintenance of reduction in supracondyar fractures of the humerus in children.
Percutaneous pinning of supracondylar fractures of the humerus. A comparative study of dunlop s traction versus percutaneous pinning not best available evidence, very low quality bender j. Supracondylar fractures of the humerus in children. Supracondylar fractures are the most common fracture of the elbow in children.
Fixation of supracondylar humeral fracture in children by medial and lateral pinning versus lateral pinning. With the recognised complications of cubitus varus, injury to any of the three major nerves around the elbow, absent radial pulse after fracture. Displaced supracondylar fractures of the humerus in. Lateral traction for fractures with medial or anterior force stretched capsule and ligamentum may reduce acetabular fragments. One hundred fiftysix children with supracondylar fractures of the humerus were.
Supracondylar fractures of the humerus in children youtube. Dunlop s traction used for supracondylar and transcondylar fractures in children used when closed reduction difficult or traumatic forearm skin traction with. Applying weight traction at the distal end of the humerus, counteracting with longitudinal traction forearm holding it at 90 degrees supracondylar elbow fractures. Outcome of supracondylar fractures of the humerus in children. They include percutaneous wire fixation of the fracture, side arm or dunlop s traction, and overhead pin traction.
In the presence of a gross swelling, dunlop traction was applied and surgery was done after the swelling subsided. Supracondylar fractures of the distal humerus are a commonly encountered injury in children. Get a printable copy pdf file of the complete article 989k, or click on a page image below. In a period of 11 years 1946 through 1957 86 children, aged 1 to 14 years, with supracondylar fractures of the humerus have been seen at the hitchcock hospital. Later the adhesive tape traction method in various forms has been recom mended by other authors dunlop 1939, maffi 1931, siris 1938. Raise the arm on a pillow when sitting or lying down loose fitting clothing, not through the. Nursing care planning of a patient with a fracture, whether in a cast or in traction, is based upon prevention of complications during healing.
A comparative study of dunlop s traction versus percutaneous pinning. Supracondylar fractures of the humerus in children are either flexion or extension in type. Displaced supracondylar fractures of the humerus in childrentreatment by dunlop s traction. This 4yearold female fell from a couch onto her outstretched hand, sustaining a supracondylar humeral fracture. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults. The association with neurovascular compromise and the potential problems of accurately reducing a displaced fracture can make treatment difficult particularly for the unwary surgeon.
Contraindicated in open fractures and skin defects. The patients in the first group were treated with dunlop s traction. Loss of carrying angle of the elbow occurred if the fracture was immobilized in a varus position. Dunlops traction used for supracondylar and transcondylar fractures in children used when closed reduction difficult or traumatic forearm skin traction with weight on upper arm elbow flexed 45 degrees. At arthrotomy the posterior horn was only seen with difficulty after pulling the meniscus well forward with. Skin traction after reduction was introduced by dunlop 1939. Type 1 supracondylar fracture of humerus from anteroposterior view. Supracondylar fractures of the humerus in children clinical. His left arm took the brunt and had severe pain and swelling in his left elbow after the injury. B pg in orthopaedics in jjm medical college, davangere. Supracondylar fractures of the humerus in children jama network.
Supracondylar humerus fx open reduction and internal fixation. Ebraheims educational animated video describing supracondylar fractures of the distal humerus in children. Between 40 and 60 per cent of all fractures in the elbow region are of this type blount et al. Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which require vigilance as imaging findings can be subtle. We studied 77 children who had sustained supracondylar fractures around the elbow during the period 19897993. Treatment is usually closed reduction and percutanous pinning crpp, with the urgency depending on whether the hand remains perfused or not. Supracondylar fracture pediatric pediatrics orthobullets. Patients with supracondylar fractures will often have prolonged period months of inability to fully extend their elbow. The usual mechanism is a fall onto the outstretched hand with hyperextension at the elbow. Sep 21, 20 supracondylar fracture humerus in children slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.