Management of Upper Extremity Fractures

  • David A. Spiegel
  • Bibek Banskota
  • Kaye E. Wilkins


The majority of upper extremity fractures in the skeletally immature can be managed nonoperatively. The health provider must have an appreciation for the remodeling potential, have a meticulous casting technique, and be able to follow patients closely to identify complications. Selected fractures will require open treatment for the best outcomes, and cases presenting in a delayed fashion are more challenging to treat and the results are less adequate.


Carpal Tunnel Syndrome Open Reduction Heterotopic Ossification Radial Head Distal Fragment 
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Suggested Reading

  1. Devnani AS. Late presentation of supracondylar fracture of the humerus in children. Clin Orthop Relat Res. 2005;431:36–41.PubMedCrossRefGoogle Scholar
  2. Elzohairy MM. Neglected posterior dislocation of the elbow. Injury. 2009;40:197–200.PubMedCrossRefGoogle Scholar
  3. Hui JH, Sulaiman AR, Lee HC, Lam KS, Lee EH. Open reduction and annular ligament reconstruction with fascia of the forearm in chronic Monteggia lesions in children. J Pediatr Orthop. 2005;25:501–6.PubMedCrossRefGoogle Scholar
  4. Kim HT, Park BG, Suh JT, Yoo CI. Chronic radial head dislocation in children, part 2: results of open treatment and factors affecting final outcome. J Pediatr Orthop. 2002;22:591–7.PubMedCrossRefGoogle Scholar
  5. Lal GM, Bhan S. Delayed open reduction for supracondylar fractures of the humerus. Int Orthop (SICOT). 1991;15:189–91.CrossRefGoogle Scholar
  6. Mahaisavariya B. Late treatment of displaced supracondylar fractures of the humerus using early wedge osteotomy. Tech Orthop. 2006;21:150–7.CrossRefGoogle Scholar
  7. Mahaisavariya B, Laupattarakasem W. Neglected dislocation of the elbow. Clin Orthop Relat Res. 2005;431:21–5.PubMedCrossRefGoogle Scholar
  8. Rodgers WB, Waters PM, Hall JE. Chronic Monteggia lesions in children. Complications and results of reconstruction. J Bone Joint Surg Am. 1996;78:1322–9.PubMedGoogle Scholar
  9. Shimada K, Masada K, Tada K, et al. Osteosynthesis for the treatment of non-union of the lateral humeral condyle in children. J Bone Joint Surg Am. 1997;79:234–40.PubMedGoogle Scholar
  10. Toh S, Tsubo K, Nishikawa S, Inoue S, Nakamura R, Harata S. Long-standing nonunion of fractures of the lateral humeral condyle. J Bone Joint Surg Am. 2002;84A:593–8.Google Scholar
  11. Wilkins KE. Nonoperative management of pediatric upper extremity fractures or don’t throw away the cast. Tech Orthop. 2005;20:115–41.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • David A. Spiegel
    • 1
    • 2
  • Bibek Banskota
    • 3
  • Kaye E. Wilkins
    • 4
  1. 1.Division of Orthopaedic SurgeryChildren’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA
  2. 2.Honorary Consultant in Orthopaedics and Rehabilitation, Hospital and Rehabilitation Centre for Disabled ChildrenJanagal, KavreNepal
  3. 3.Department of OrthopedicsHospital and Rehabilitation Center for Disabled Children (HRDC)Janagal, KavreNepal
  4. 4.Department of Orthopedics and PediatricsUniversity of Texas Health Science Center at San Antonio, The Children’s Hospital of San Antonio, formerly Christus Children’s HospitalSan AntonioUSA

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