Flexion supracondylar fracture
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Flexion supracondylar humeral fractures account for only 2-4% of all supracondylar fractures 1.
Unlike the much more common extension supracondylar fracture which are seen in children, flexion fractures are seen in older (adult) patients.
They are usually the result of a fall directly onto a flexed elbow. Due to direct trauma in the flexed position, the fracture begins posteriorly and the anterior periosteum acts as a hinge resulting in the flexed fracture pattern 4.
The humeral condyles are displaced anteriorly relative to the humeral shaft 3. Use of the anterior humeral line is important as it will be positioned posterior to the capitellum 4.
Treatment and prognosis
These fractures require open reduction and pin fixation. Care must be taken to identify and mobilize the ulnar nerve, lest it become trapped in the fracture 2.
- 1. Baker CL, Plancher KD. Operative Treatment of Elbow Injuries. Springer Verlag. (2002) ISBN:0387989056. Read it at Google Books - Find it at Amazon
- 2. Beaty JH, Rockwood CA, Kasser JR. Rockwood and Wilkins' fractures in children. Lippincott Williams & Wilkins. (2009) ISBN:1582557845. Read it at Google Books - Find it at Amazon
- 3. Jeffrey Norton, Philip S. Barie, Ralph R. Bollinger, Alfred E. Chang, Stephen Lowry, Sean J. Mulvihill, Harvey I. Pass, Robert W. Thompson. Surgery. (2009) ISBN: 9780387681139
- 4. Vaquero-Picado A, González-Morán G, Moraleda L. Management of supracondylar fractures of the humerus in children. EFORT Open Rev. 2018 Oct 1;3(10):526-540. doi: 10.1302/2058-5241.3.170049. PMID: 30662761; PMCID: PMC6335593.