| Fractures & Dislocations
of the Child's Elbow > Supracondylar Fracture of the Humerus in a Child What Is a Supracondylar Fracture of the Humerus? The two bones in the lower arm are the ulna and radius. The upper arm bone is the humerus. The two lower arm bones meet the upper arm bone at the elbow joint. Basically, a supracondylar fracture of the humerus is a broken elbow. But it refers to a specific portion of the elbow. In this type of fracture, the humerus bone is involved. The humerus is the long thick bone in the upper arm. The end where it meets the shoulder is called the proximal end. Where it meets the elbow joint is called the distal end. In children whose bones are not yet fully developed, there is a small gap at each end of the bone called a growth plate. A supracondylar fracture of the humerus occurs above the growth plate at the distal end. At this distal end there are two rounded bony knobs called condyles. The condyle attaches to other bones, tissues and muscles. If it is injured, muscles and nerves can be affected and that in turn affects whether the elbow can bend or the arm can move. One of the most common kinds of broken elbows in children between the ages of 2 and 12 years is a supracondylar fracture of the humerus. This break occurs right above the condyle and the growth plate, which gives it the name supracondylar. Recommended treatment and follow-up care is based on whether or not the bone has been displaced or moved from where it belongs. With an elbow fracture, there are several complications that can develop of which the doctor needs to check. One of the most common kinds of complication is damage to the nerves that in some cases causes paralysis. Severely displaced supracondylar fracture may rupture the brachial artery and can result in Volkmannís disease, a permanent forearm and hand deformity. Causes of a Supracondylar Fracture of the Humerus? Most often, a supracondylar fracture of the humerus is caused by a fall. The child may stretch out his or her hand and the force from the impact may be enough to cause a break in the bone. But any trauma to the area, such as an injury from a car accident, may also be a cause. In general, bone fractures are classified by the amount of displacement of the bone that occurs. Most supracondylar fractures of the humerus are displaced fractures, meaning one or both of the condyles have been moved from where they normally belong. Nondisplaced fractures are less severe, and the bone does not separate into fragments. Displaced fractures means the bone has separated and needs to be rejoined. If a fracture is comminuted there are more than two fragments of bone and the break is severe. Around the condyles near the elbow are two fat pads that cushion the bone and help keep it in place. In a supracondylar fracture of the humerus, one or both of these may be displaced and detected on x-rays. Symptoms of a Supracondylar Fracture of the Humerus?
Treatment of a Supracondylar Fracture of the Humerus? Your child's doctor will check the arm for signs of damage to the blood vessels and nerves. He or she will ask for details about how the injury occurred, and will likely want to know about any previous conditions of the arm, hand, and shoulder. The doctor will also check the wrist and shoulder for related injuries. If the doctor thinks there is a supracondylar fracture of the humerus, he or she will order some x-rays. The x-rays will reveal details about the injury. If there is no sign of a bone fracture, the doctor will likely look at the position of the fat pads to see if the condyles have been displaced. If there is no displacement of the bone or the fat pads, the most common form of treatment is to immobilize the arm. Most often a splint will be used and parents will need to check to make sure the child can move his or her fingers. The splint will probably stay on for about three weeks to give the bone time to heal. If the fracture is displaced, the bones need to be reduced - which just means moved back into position. In the case of a supracondylar fracture of the humerus, a pin will be needed. The pin is used to hold the bones in place while they heal. Appropriate pain medication may be prescribed depending on your child's level of pain. Acetaminophen is often recommended for mild pain. With a fractured condyle it is important to follow-up the initial treatment to be sure that the bone is rejoining as it should while it heals. Since there is also a small chance of infection from the pin, the doctor will check for that, too. The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician. © 2000 DynoMed.com, LLC, Indianapolis, IN |