Supracondylar Elbow Fracture • Most common elbow fracture in children, peak age 5-7 • When looking at an elbow x-ray review alignment (anterior radiocapitellar lines), fat pads (anterior & posterior) and bone cortex • If a fracture cannot be identified but anterior sail sign or posterior fat pad is seen, or radiocapitellar line is disrupted, treat as non-displaced supracondylar fracture' • Ossification centers: "CRITOE"; capitellum (age 1), radial head (age 3), internal epicondyle (age 5), trochlea (age 7), olecranon (age 9), external epicondyle (age 11) • Mechanism: Fall onto outstretched hand • Exam: Swelling and refusal to move elbow • Possible associated injuries: Neuropraxia (anterior interosseous nerve [can't make A-OK sign] most common), brachial artery injury (leads to Volkmann contracture), compartment syndrome • ED Management: Pain control • Splint: Posterior long arm • Ortho consult: No, if Type I; Yes, if Types II-IV • Disposition: Type l, DC with ortho follow-up within 1 week; Types II-IV, pending orthopedic recommendations MH/CCF/CWRU EM Res @MetroHealth_EM #Supracondylar #Fracture #Elbow #Humerus #Radiology #XRay #Diagnosis #Management #Orthopedics #MSK
