Supracondylar fracture of the humerus

A supracondylar fracture most commonly occurs in children when they fall on the hand with the elbow bent.

The distal fragment of bone is moved backwards and is tilted, although very rarely it is displaced anteriorly.

Supracondylar fractures in children have been classified according to Gartland. Fractures are either extension or flexion-type injuries depending on the mechanism of injury and the direction of displacement of the distal fragment. Extension-type fractures are the most common, and the distal fragment is extended compared to the proximal fragment.

The modified Gartland classification is as follows:

• Type I – Nondisplaced or minimally displaced (<2 mm) fractures
• Type IIA – Displaced fractures (>2 mm) with intact posterior hinge
• Type IIB – Displaced fracture with intact posterior hinge and malrotation
• Type III – Completely displaced fractures with disruption of the posterior periosteum
• Type IV - Completely displaced fractures with multidirectional instability

Reference

1. Leitch KK et al. Treatment of multidirectionally unstable supracondylar humeral fractures in children. A modified Gartland type-IV fracture. J Bone Joint Surg Am. 2006 May;88(5):980-5.