Supracondylar humerus fractures are common pediatric injuries, particularly in children aged 5 to 7 years, typically resulting from falls onto an outstretched hand or direct blows to the elbow. These fractures occur just above the elbow joint, within the distal humerus, and are classified into three types based on the degree of displacement and the relationship of the fractured fragments. The most critical aspect of these fractures is their potential for complications, particularly neurovascular injuries, which can involve the median, radial, or ulnar nerves, and the brachial artery. Clinical presentation often includes pronounced swelling, tenderness, and deformity around the elbow, with the child commonly holding the arm in a protective posture. Performing a thorough neurovascular examination is paramount, as signs of nerve damage or vascular compromise are potential surgical indications. Diagnosis primarily relies on clinical examination complemented by radiographic evaluation, where X-rays can reveal the fracture's pattern and alignment. In particular, the presence of an abnormal anterior humeral line or the posterior fat pad sign can indicate the need for surgical intervention. Treatment options vary based on the fracture's classification; non-displaced fractures may be managed conservatively with immobilization in a cast, usually for about 3 to 4 weeks, followed by gradual rehabilitation to restore range of motion and strength. In contrast, displaced supracondylar humeral fractures typically require surgical intervention, often through percutaneous pinning to stabilize the fracture fragments. This surgical approach minimizes the risk of malunion or nonunion, ensuring proper alignment and healing. Postoperatively, careful monitoring for neurovascular integrity remains essential, as complications such as compartment syndrome can arise. Additionally, potential long-term consequences include elbow stiffness or cubitus varus, commonly known as "gunstock deformity." Rehabilitation and follow-up care focus on restoring function, with physical therapy introduced progressively to enhance recovery. Families should be educated about the importance of adhering to follow-up appointments and engaging in prescribed rehabilitation exercises to optimize outcomes. As with any pediatric fracture, the psychological impact on the child, given the potential for activity limitations and the adjustment to living with a cast or surgical apparatus, should not be overlooked. Therefore, a multidisciplinary approach involving orthopedic surgeons, rehabilitation specialists, and, when necessary, psychological support can facilitate comprehensive care. Ultimately, with appropriate and timely management, the prognosis for children with supracondylar humerus fractures is generally excellent, with most achieving full functional recovery.
