This is one of the most serious fracture in childhood often associated with complications. fracture of distal humerus usually involves the supracondylar portion of humerus and are extra-articular. Basically, a supracondylar fracture of the humerus is a broken elbow. But it refers to a specific portion of the elbow. In this type of fracture, the humerus bone is involved.
The fracture is caused by fall on an outstretched hand. As the hand strikes the ground the elbow is forced into hyperextension resulting in fracture of humerus above the condyles.
The fracture line runs transversely through the distal metaphysic of humerus just above the condyles.
TYPES: depending on displacement of distal fragments.
FLEXION TYPE: the distal fragment is flexed(tilted forwards)in relation to proximal fragment.
EXTENSION TYPE: is more common here the distal fragment is extended(tilted backwards) in relation to proximal fragment.
Commonly the supracondylar fracture is displaced. the distal fragments may be displaced in following directions.:
PRESENTING COMPLAINTS: history of fall followed by pain, swelling , deformity and inability to move the affected elbow.
EXAMINATION: when presented early before significant swelling has occurred the following clinical signs may be observed:
When presented late gross swelling makes it difficult to appreciate these signs, thus making clinical diagnosis difficult.:
RADIOLOGY: easy to diagnose the fracture because of wide displacement following displacement are seen on X-RAY:
In an anterior posterior view one can see the:
In lateral view:
Undisplaced fractures require immobilization in an above elbow plaster slab,with the elbow in 90 degrees flexion.In all displaced fractures,the person should be admitted to a hospital because serious complications can occur within the the first 48 hours.
The following methods are used in displaced fractures.
Technique of closed reduction:It is carried out in the following steps
In some cases,it is not possible to achieve a good position by closed methods,or the fracture gets redisplaced after reduction.In such cases,open reduction and K-wire fixation is necessary.This is also used as a first line of treatment in some open fractures and in those requiring exploration of the brachial artery for suspected injury.
PHYSIOLINE’S SPECIALIZED PHYSIOTHERAPY HAS VITAL ROLE TO PLAY
At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:
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