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Gartland Classification of Supracondylar Fractures

The document outlines supracondylar fractures classified into three types based on displacement. It details clinical features, including patient history and physical examination findings, as well as necessary investigations like X-rays. Treatment options vary based on displacement, ranging from splinting to surgical intervention, with potential complications highlighted.

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Kaung Khant
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12 views3 pages

Gartland Classification of Supracondylar Fractures

The document outlines supracondylar fractures classified into three types based on displacement. It details clinical features, including patient history and physical examination findings, as well as necessary investigations like X-rays. Treatment options vary based on displacement, ranging from splinting to surgical intervention, with potential complications highlighted.

Uploaded by

Kaung Khant
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Ortho Eindra

SUPRACONDYLAR FRACTURE
GARTLAND’S CLASSIFICATION

 Type I  complete # without displacement


 Type II  displaced # with intact posterior cortex
 Type III  complete # with typical displacement & overlapping of fractured fragments

CLINICAL FEATURES

History

 Age – most common in childhood


 Sex – more common in male
 MOI – fall on an outstretched hand ( hyperextension injury )
 Chief complaint
 Pain & swelling around the elbow region
 Inability to move elbow
 Deformity

Physical Examination

 Look
 Attitude of patient  the child holds his forearm with other hand & the affected
limb is flexed at elbow
 Swelling & bruises around the elbow
 Deformity  distal segment, backward shift & backward angulation “ S-shaped
deformity ‘’

 Feel
 Localized bony tenderness
 Local bony landmarks ( to differentiate elbow dislocation )
 Distal neurovascular status ( to exclude associated brachial artery & nerve injury )
 Crepitus can be heard

 Move
 Painful & restricted movement of elbow joint

 Measure
 Length of arm is shortened
 Elbow circumference is increased

INVESTIGATION
1. X-ray of elbow region ( AP & lateral view )
 AP view
 Transvere # above the supracondylar region
 Proximal impaction
1
Ortho Eindra

 Medial displacement
 Lateral view
 Posterior displacement, posterior angulation & proximal impaction

 Can exclude associate injury to elbow joint & other part of humerus

TREATMENT

General
 Adequate analgesia
 Temporary splintage
 Nutritional support

Specific
 If NO displacement
 No reduction just POP posterior slab for 3-4wk

 If displacement (+)  reduction


 Take informed consent
 Inform OT
 Under GA, close reduction is done
 Traction & counter traction for proximal impaction
 Correct displacement & angulation
 Maintain at stable position of flexion of elbow at 90 at neutral or supinated
position
 During procedure  palpating the radial artery is essential to detect
vascular complication
 Retaining of reduction by POP posterior slab ( midarm to knuckles )
 Before removing POP  recheck X-ray is taken

 If unstable  percutaneous K-wire fixation

Indications for Open Reduction


 Failure of closed reduction
 Open #
 Associated vascular injury

 Rehabilitation
 Early mobilization
 Active exercise of shoulder joint & hand

COMPLICATION
1. Malunion ( Cubitus varus or valgus deformity )
2. Limitation of movement of elbow joint
3. Myositis ossificans traumatica
4. Volkmann’s ischaemic contracture
2
Ortho Eindra

5. Vascular injury ( eg: Brachial artery laceration )


6. Nerve injury ( Ulnar, median or radial )

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