Supracondylar Humerus Fractures

Because Supracondylar Humerus Fractures are rotationally unstable and have a high rate of neurovascular complications, they should be considered an orthopedic emergency. For those fractures that are displaced, unstable or cannot be reduced without jeopardizing the blood supply, treatment typically involves anatomical reduction (i.e. re-alignment of the fracture by careful manipulation under anesthetic) followed by surgical external or internal fixation to stabilize the fracture (e.g. using pins). This may be followed by the use of a splint, plaster cast, sling or brace for a number of weeks.

For those isolated Supracondylar Humerus Fractures that are not displaced treatment typically involves immobilization either via external or internal fixation, a splint or plaster cast for approximately 4 – 6 weeks.

The orthopedic surgeon will determine the most suitable treatment for the fracture based on a number of factors such as the location, type and severity of the fracture.

Evaluation of the fracture with follow up X-rays is important to ensure the fracture is healing in an ideal position. Once healing is confirmed and the plaster cast has been removed, rehabilitation can generally begin as guided by the treating physiotherapist.

One of the most important components of rehabilitation following a Supracondylar Humerus Fracture is that the patient rests sufficiently from any activity that increases their pain. Activities which place large amounts of stress through the humerus should also be avoided particularly lifting, weight bearing or pushing activities. Rest from aggravating activities allows the healing process to take place in the absence of further damage. Once the patient can perform these activities pain free, a gradual return to these activities is indicated provided there is no increase in symptoms. This should take place over a period of weeks to months with direction from the treating physiotherapist.

Ignoring symptoms or adopting a 'no pain, no gain' attitude is likely to cause further damage and may slow healing or prevent healing of the fracture altogether.

Patients with a Supracondylar Humerus Fracture should perform pain-free flexibility and strengthening exercises as part of their rehabilitation to ensure an optimal outcome. This is particularly important, as soft tissue flexibility and strength are quickly lost with immobilization. The treating physiotherapist can advise which exercises are most appropriate for the patient and when they should be commenced.

Supracondylar Humerus Fractures