This 2011 AAOS clinical practice guideline systematically reviews the literature on pediatric supracondylar humerus fractures to produce 14 graded treatment recommendations — covering immobilization, reduction technique, pin configuration, vascular compromise management, and rehabilitation — with the goal of standardizing care for the most common elbow fracture in children.
When you see a displaced Gartland type II or III supracondylar fracture, the default is closed reduction and lateral percutaneous pinning — lateral-only entry is preferred to avoid iatrogenic ulnar nerve injury, and a pulseless, poorly perfused hand mandates emergent reduction followed by antecubital exploration if perfusion does not return.
For nondisplaced fractures, immobilize and favor a posterior splint over collar and cuff for better early pain control.
This 2011 AAOS clinical practice guideline systematically reviews the literature on pediatric supracondylar humerus fractures to produce 14 graded treatment recommendations — covering immobilization, reduction technique, pin configuration, vascular compromise management, and rehabilitation — with the goal of standardizing care for the most common elbow fracture in children.
When you see a displaced Gartland type II or III supracondylar fracture, the default is closed reduction and lateral percutaneous pinning — lateral-only entry is preferred to avoid iatrogenic ulnar nerve injury, and a pulseless, poorly perfused hand mandates emergent reduction followed by antecubital exploration if perfusion does not return.
For nondisplaced fractures, immobilize and favor a posterior splint over collar and cuff for better early pain control.