Pediatric Supracondylar Humerus Fracture

A pediatric supracondylar humerus fracture is a type of broken bone that happens just above the elbow in the upper arm bone (the humerus -Figure 1). It is most common in children, especially those between the ages of 5 and 7 because their bones are still growing and are more likely to break during a fall. These fractures usually happen when a child falls on an outstretched hand while playing, running, or climbing. The fracture occurs just above the elbow joint (supracondylar region of the humerus) because this is where the weakest part of the bone is at that age. Fortunately, this type of fracture typically does not involve the growth plates in children. Adults can also get this injury, but it’s much less common.

Diagnosing a Pediatric Supracondylar Humerus Fracture

To diagnose a supracondylar humerus fracture in a child, a doctor will start with a physical exam to look for swelling, bruising, or changes in the shape of the elbow. They’ll also check for nerve or blood vessel injuries. An X-ray is the main tool used to confirm the fracture and see if it is displaced, and if so, how badly the displacement is. Sometimes, doctors may use a CT scan if they need a more detailed look, especially if the fracture is complex or hard to see on regular X-rays.

Treatment of Pediatric Supracondylar Fractures

Treatment of a supracondylar humerus fracture in a child depends on how serious the break is -specifically how displaced or out of position the fracture is. For less severe fractures where the bones haven’t moved too far out of place, doctors may treat it by putting the arm in a splint or cast to keep it still while it heals. Pain medicine and regular check-ups with follow-up X-rays help make sure the bone is healing correctly.

If the fracture is more serious and the bones are out of alignment, surgery is usually needed. In most cases, this means giving the child an anesthetic, manipulating the bones back into position, confirming that the bones are back in a good position with a portable x-ray machine (fluoroscopy), and often placing pins through the skin to hold the bone in place while they heal (Figure 2). This is called a closed reduction with pinning. The pins are usually removed a few weeks later in the clinic (they usually come out easily), once the bone has started to heal. In rare cases, if the injury is very complex, more extensive surgery with screws or plates may be necessary.

Long-Term Results of a Pediatric Supracondylar Humerus Fracture

Most children with a supracondylar humerus fracture recover very well, especially if treated quickly and properly. The bone usually heals in about 3 to 6 weeks. Physical therapy may be needed to regain strength and movement in the elbow. In rare cases, there may be long-term problems such as limited movement, nerve injury, or changes in the way the arm looks, but with good care, these are uncommon.

Edited by Stephen Pinney MD May 13th 2025