Pediatric supracondylar humerus fractures are common injuries encountered in children, especially those aged between 5 and 7 years, often resulting from falls onto an outstretched hand when engaging in typical play activities. This type of fracture occurs just above the elbow joint in the humerus and is classified into two major types: extension and flexion fractures, with extension fractures being more prevalent due to the mechanism of injury. The extension type typically occurs when the child falls forward, causing the outstretched arm to absorb the force, leading to a fracture that generally presents with significant periarticular swelling, pain, and an inability to move the elbow. In contrast, flexion fractures may occur when a child falls backward but are less common. The clinical evaluation of such fractures is crucial to avoid complications, including potential neurovascular compromise, which can arise due to the displacement of fracture fragments or hematoma formation. Medical practitioners often use the Gartland classification system to assess the fracture's severity, guided by anteroposterior and lateral radiographs of the elbow. A Type I fracture is non-displaced and can be treated conservatively, while a Type II fracture is displaced but with intact posterior cortex, necessitating more careful monitoring, and Type III fractures are completely displaced in various directions, which typically require surgical intervention. The management of these fractures varies significantly depending on the type and degree of the injury. Non-displaced fractures often can be treated with immobilization using a cast or splint, but for displaced fractures, particularly those classified as Type II and Type III, surgical intervention such as closed reduction and percutaneous pinning (CRPP) is usually indicated to restore proper alignment and stability. Early intervention is key in preventing complications, such as malunion, cubitus varus (also known as "gunstock deformity"), or nerve injuries, particularly to the median and radial nerves. In the postoperative period, physical therapy may be implemented after adequate healing to restore range of motion and strength. The prognosis for pediatric supracondylar humerus fractures is generally favorable, especially when addressed timely and appropriately, but vigilance is necessary to monitor for complications. Parents and caregivers play a vital role in rehabilitation by ensuring adherence to the rehabilitation protocols and encouraging safe play practices that minimize the risk of future injuries. Ultimately, an understanding of the injury mechanism, prompt assessment, and appropriate intervention strategies are paramount steps in the successful management of pediatric supracondylar humerus fractures, ensuring optimal outcomes for young patients.
