Supracondylar fracture (classification)
Supracondylar fracture classification is based on the degree and direction of displacement, and the presence of intact cortex. It applies to extension supracondylar fractures rather than the rare flexion supracondylar fracture.
Classification is based on the Gartland system:
type I: undisplaced or minimally displaced
- Ia: undisplaced in both projections
- Ib: minimal displacement, medial cortical buckle, capitellum remains intersected by anterior humeral line
type II: displaced but with intact cortex
- IIa: posterior angulation with intact posterior cortex; anterior humeral line does not intersect capitellum
- IIb: rotatory or straight displacement but fracture remains in contact
type III: completely displaced
- IIIa: complete posterior displacement with no cortical contact
- IIIb: complete displacement with soft tissue gap (i.e. bone ends held apart by interposed soft tissues)
While the fracture type is not usually explicitly detailed in radiological reports, description of the fracture should include the degree and direction of displacement as well as whether the cortex is involved, e.g. none, buckle or break. Ultimately, the injury type determines treatment.