Page 97 - Orthopedic Casting Manual

2.3.1 Fracture Type(s) for Long Arm

Cast

Supracondylar Humerus Fractures
✓ Clinically Relevant Anatomy: The distal humerus comprises the medial and

lateral condyles, the olecranon fossa, and the supracondylar region. The
brachial ar ter y and median ner ve traverse the cubital fossa near the
supracondylar region, making them vulnerable in these fractures.
✓ Epidemiological/Etiology/Mechanism of Injur y: Supracondylar fractures

account for approximately 60% of elbow fractures in children under 15 years
old LRasool, 2020M.
✓ Mechanism: These fractures t ypically resul t from a fall on an outstretched

hand LFOOSH) with the elbow hyperex tended, leading to compression or
shear forces on the supracondylar region.
✓ Clinical Characteristics/Presentation: Severe pain, swelling, and defor mit y at

the elbow; Limited or absent elbow flexion/ex tension., possible neurovascular
compromise indicated by pallor, pulselessness, or paresthesia.
✓ Fracture Diagnosis Process: Imaging: Anteroposterior LAP) and lateral

radiographs of the elbow are diagnostic. A "posterior fat pad sign" suggests
occul t fractures.
✓ Clinical Tests: Neurovascular assessment for radial, median, and ulnar ner ve

function.
✓ Differential Diagnosis/Associated Injuries: Elbow dislocation; Intercondylar

fractures
✓ Treatment/Management Considerations: Closed reduction and immobilization

in a long ar m cast with the elbow flexed to 90 degrees if neurovascular status
per mits; Post-reduction radiographs to confir m alignment; Regular monitoring
for compar tment syndrome.