Injured Elbow After a Fall? It Could Be a Supracondylar Fracture
Supracondylar humerus fractures are the most common type of elbow injury in young children. Prompt diagnosis and treatment are vital to protect nerves, blood supply, and long-term arm function. The Arm Doc offers expert paediatric fracture care with full recovery support.
What Is a Supracondylar Humerus Fracture?
This fracture occurs just above the elbow joint, in the narrow part of the lower (distal) humerus bone. It most often happens when a child falls on an outstretched hand.
- Common in children aged 5–8
- Most fractures are extension-type, meaning the broken part of the bone shifts backwards
- Less than 5% are flexion-type, where the bone shifts forwards
Signs and Symptoms
- Pain and swelling around the elbow
- Reduced movement of the arm or refusal to use it
- A visible bend or “S-shaped” deformity
- Tingling, numbness, or changes in hand colour (suggesting nerve or blood vessel involvement)
Why Prompt Diagnosis Matters
Supracondylar fractures can damage nearby:
- Nerves (especially the median, anterior interosseous, and radial nerves)
- Blood vessels (notably the brachial artery)
- Muscle compartments, leading to rare but serious complications such as compartment syndrome
Diagnosis
- Physical examination: Doctors check circulation, nerve function, and look for skin puckering or deformity
- X-rays: Front and side views help confirm the fracture and guide treatment
- Look for signs like a “posterior fat pad” (fluid in the elbow)
- Assess if the anterior humeral line passes through the middle of the elbow bone (capitellum)
Fracture Classification
Using the Gartland system:
- Type I: Undisplaced – bone pieces are still aligned
- Type IIA: Displaced with angulation only
- Type IIB: Displaced with both angulation and rotation
- Type III: Completely displaced – bones no longer touching
- Type IV: Unstable in all directions – often discovered during surgery
Treatment Options
Non-Surgical
For Type I and select IIA fractures:
- Backslab cast worn for 3 weeks
- Elbow kept bent at 90 degrees
- Regular monitoring to ensure healing
Surgical
For more serious fractures (Type IIB–IV, or any with poor circulation):
- Closed Reduction and Percutaneous Pinning (CRPP): Realignment and temporary wire fixation
- Pin Techniques:
- Lateral pins: Lower risk of nerve damage
- Crossed pins: More secure but higher risk to the ulnar nerve
Open surgery may be needed if closed methods fail or blood flow is compromised.
Recovery and Rehabilitation
- Pins removed at 3–4 weeks
- Early exercises improve range of motion
- Most children regain full function within 6–12 months
- Physiotherapy is not always needed but may be advised in complex cases
Clinical Pearls / Key Points
- Anterior interosseous nerve palsy is the most common nerve injury; check for “OK sign”
- Cubitus varus (“gunstock deformity”) is the most common long-term complication from malalignment
- Pale, pulseless hand after injury needs emergency attention – may require urgent surgery
Patient FAQs
Is this injury common in children?
Yes. It’s the most common elbow fracture in children, especially after a fall.
How do I know if my child needs surgery?
Surgery is advised if the bones are badly out of place, nerves or blood vessels are affected, or if a cast won’t keep the bones aligned.
How long will recovery take?
Initial healing takes 3–4 weeks. Full motion and strength typically return by 6–12 months.
Is the injury likely to happen again?
Not usually, but future injuries depend on activity levels and bone health.
Call-to-Action
If your child has elbow pain or swelling after a fall:
- Call: 020 3384 5588
- Email: Info@TheArmDoc.co.uk
- Visit: www.TheArmDoc.co.uk
For aftercare tips and home exercises, browse our Patient Resource Centre.
Disclaimer
This information is intended for general education. It should not be used as a substitute for professional medical advice. Always consult a qualified healthcare provider for individual care.