Supracondylar Humerus Fracture Flexion Type

Abstract

An 8-year-old boy sustained an injury to his left elbow while playing on the playground. Left elbow radiographs showed a distal humerus supracondylar fracture with the distal fragment translated anteriorly indicating a flexion-type supracondylar injury. The injury was isolated, and the neurovascular exam (with special attention to the ulnar nerve) was normal. Ulnar nerve palsy can be present in around 10% of flexion-type fractures. The decision was made to proceed with closed reduction and percutaneous pinning. The need for a possible open reduction was discussed with the family since a higher risk for open reduction has been reported with flexion-type fractures. In our case, the fracture was closed reduced with placement of three percutaneous lateral pins. The patient was discharged home later the same day after checking the neurovascular status of his left upper extremity. Radiographic follow-up evaluations were performed at 1 week and 4 weeks postoperatively. Once healing was confirmed, pins were removed and the cast discontinued. At the 8-week clinic visit, he had full range of motion of his left elbow with no malalignment.