9/10/2023 0 Comments Left supracondylar fracture icd 10![]() Type IIb always required reduction +/- fixation. Although traditionally these fractures were treated non-operatively with cast immobilization of the flexed arm to 120 degrees, this however dramatically increases the risk of ischemic contracture ( Volkmann contracture), as such most authors recommend percutaneous pinning ( CRIF) and cast immobilization with less than 90 degrees flexion 5,7. Type IIa usually requires reduction (especially when angulation is more than 20 degrees). Type I (undisplaced) fractures are stable and can be treated with cast immobilization for approximately 3 weeks. Management depends on the type and degree of angulation 5,7. Repeating radiographs after inflammation has subsided may be helpful in demonstrating the fracture this is typically done 7-10 days later. Even in the absence of an obvious fracture, the patient needs to be treated with a cast. remember to assess elbow centers of ossification ( CRITOE)Īlthough in many cases the fracture is easily seen, in some instances all that may be seen is soft tissue swelling or an anterior fat pad sign.assess alignment of the radiocapitellar joint.assess for joint effusion (anterior and posterior fat pad sign).alignment of the radius and ulna with the distal humerus.angulation (use the anterior humeral line).location and especially presence of articular involvement.anterior humeral line should intersect the middle third of the capitellum in most children 2 although, in children under 4, the anterior humeral line may pass through the anterior third without injuryĪfter ensuring that the films are technically adequate, assessment should include:.anterior fat pad sign (sail sign): the anterior fat pad is elevated by a joint effusion and appears as a lucent triangle on the lateral projection.In such cases assessing for indirect signs is essential: Often, however, no fracture line can be identified. Lateral and AP radiographs are usually sufficient, and in many instances demonstrate an obvious fracture. type II: displaced with intact posterior cortex.Radiographic featuresĬlassification of supracondylar fractures is relatively straightforward and based on three types 6,7: They result in an extra-articular fracture line, and (when displaced) posterior displacement of the distal component. The humerus fractures anteriorly initially and then posteriorly. ![]() When this occurs, the olecranon acts as a fulcrum after engaging in the olecranon fossa. There are two types of supracondylar fractures: extension (95-98%) and flexion (<5%) types.Įxtension type supracondylar fractures typically occur as a result of a fall on a hyper-extended elbow. They occur in older individuals and require different management and are discussed separately: see flexion supracondylar fracture 5. Rarely (<5%) supracondylar fractures are seen due to a fall onto the flexed elbow. These injuries are almost always due to accidental trauma, such as falling from a moderate height (bed/monkey-bars) 4. These fractures are more commonly seen in boys 4 and are the most common elbow fractures in children (55-80%) 8. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults 90% are seen in children younger than 10 years of age, with a peak age of 5-7 years 4,6.
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