Treatment

• in general the displaced supracondylar fracture is reduced - a small degree of displacement is acceptable (15 degrees anteriorly, 10 degrees laterally or medially)
  • an important point is that the amount of flexion at the elbow must be carefully monitored with respect to the pulse distally - flexion must be decreased if the pulse is compromised.
• non-operative management is acceptable for nondisplaced Gartland I and minimally displaced Gartland IIA fractures
  • involves immobilization in a collar and cuff or an above-elbow cast with the elbow in 80 to 90 degrees of flexion for three to four weeks.
• surgical management is indicated for displaced Gartland II and Gartland III fractures
  • urgent surgical management is indicated for patients with neurovascular compromise, compartment syndrome, and open fractures
  • surgical management involves closed reduction and percutaneous pinning with K-wires for closed injuries
  • open reduction may be required for failed closed reduction, irreducible fractures, and vascular exploration
• in children up to 4 years union takes place after 3-4 weeks. In children 4-8 years old union takes 4-5 weeks.
• supracondylar fractures in adults require 6-8 weeks of immobilisation.

Reference

1. Shenoy PM, Islam A, Puri R. Current Management of Paediatric Supracondylar Fractures of the Humerus. Cureus. 2020 May 15;12(5):e8137.