Cutting edge Orthopedics

Supracondylar Humerus Fractures • 31  evidence to guide the management of the rare complications of supracondylar humerus fractures, such as avascular necrosis. The current American Academy of Orthopaedic Surgeons Clinical Practice Guideline has 14 treatment recommendations. Of the 14 recommendations, there are no strong recommendations and only two moderate strength recommendations. The remainder is primarily inconclusive (eight recommendations), along with two weak and two consensus recom- mendations. This signifies a clear lack of evidence-based understanding regarding the manage- ment of supracondylar humerus fractures and many opportunities for new studies to improve our knowledge base and outcomes. References 1. Cheng JC, Shen WY. Limb fracture pattern in different pediatric age groups: a study of 3,350 children. J Orthop Trauma. 1993;7(1):15–22. 2. Cheng JC, Ng BK, Ying SY, Lam PK. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop. 1999;19(3):344–50. 3. Cheng JC, Lam TP, Maffulli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatr Orthop B. 2001;10(1):63–7. 4. FarnsworthCL, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998;18(1):38– 42. 5. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg Am. 2008;90(5):1121– 32. 6. Brubacher JW, Dodds SD. Pediatric supracondylar fractures of the distal humerus. Curr Rev Musculoskelet Med. 2008;1(3–4):190–6. 7. Thompson JC. Arm. In: Netter’s concise orthopaedic anatomy. Philadelphia: Saunders; 2010. p. 109–38. 8. Nduaguba A, Flynn J. Supracondylar humerus fracture. In: Abzug JM, Kozin SH, ZlotolowDA, editors. The pediatric upper extremity. NewYork: Springer; 2015. p. 1121–36. 9. Abzug JM, Kozin SH. Fractures of the Pediatric Elbow I: Supracondylar Humerus, Lateral Condyle, Transphyseal Distal Humerus andCapitellumFractures. In HermanMJ, Horn BD (eds): Contemporary Surgical Management of Fractures & Complications, Volume 3 Pediatrics. Jaypee, 2014. Chapter 3, pp35–69. Fig. 24: Oblique radiograph demonstrating hypoplasia of the trochlea due to avascular necrosis. This has been termed “fishtail deformity” due to the shape of the distal humerus (Courtesy of Shriners Hospital for Children, Philadelphia, PA). omy, and ulnar nerve transposition [ 111 ]. consensus recommendations. This signifies a clear lack of evidence-based understanding regarding the management of supracondylar humerus fractures and many opportunities for new studies to improve our knowledge base and outcomes. References 1. Cheng JC, Shen WY. Limb fracture pattern in differ- ent pediatric age groups: a study of 3,350 children. J Orthop Trauma. 1993;7(1):15–22. 2. Cheng JC, Ng BK, Ying SY, LamPK. A10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop. 1999;19(3):344–50. 3. Cheng JC, Lam TP, Maffulli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatr Orthop B. 2001;10(1):63–7. 4. Farnsworth CL, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998;18(1):38–42. 5. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg Am. 2008;90(5):1121–32. 6. Brubacher JW, Dodds SD. Pediatric s pracon- dylar fractures of the distal humerus. Curr Rev Musculoskelet Med. 2008;1(3–4):190–6. Fig. 4.24 Oblique radiograph demonstrating hypoplasia of the trochlea due to avascular necrosis. This has been termed “fishtail deformity” due to the shape of the distal humerus (Co rtesy of Shrine s Hosp tal for Children, Philadelphia, PA)