Cutting edge Orthopedics

Supracondylar Humerus Fractures Stephanie A. Russo, JoshuaM. Abzug Electronic Supplementary Material: The online version of this chapter (doi:10.1007/978-3-319-68004-0_4) contains supplementary material, which is available to authorized users. S.A. Russo, M.D., Ph.D. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center—Hamot, 201 State Street, Erie, PA, USA e-mail: sarusso@udel.edu J.M. Abzug, M.D. (  ) Departments of Orthopedics and Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA e-mail: jabzug@umoa.umm.edu Introduction Supracondylar humerus fractures are the most common pediatric elbow fracture and the second most common pediatric fracture overall [1, 2]. According to Cheng and colleagues (1999), supra- condylar humerus fractures constitute approximately 18% of all fractures in children. They are second only to distal radius fractures, which represent approximately 20% of pediatric fractures. When stratified by age, supracondylar humerus fractures represent the most common fracture among both infant to 3-year-olds and 4–7-year-olds. In these age groups, supracondylar humerus fractures comprise approximately 27 and 32% of fractures, respectively [2]. Supracondylar humerus fractures occur most frequently in children ages 5–7 years [3, 4]. There is no clear differ- ence in incidence between genders [3–5]. Anatomy Supracondylar Region The distal metaphyseal portion of the humerus forms the supracondylar region. This region marks the transition between the thicker cortical bone of the humeral shaft proximally and the medial condyle (medial epicondyle and trochlea) and lateral condyle (lateral epicondyle and capitel- lum) of the humerus distally. In the supracondylar region, the cortex is relatively thin to accom- modate the olecranon fossa posteriorly and coronoid and radial fossae anteriorly [5–7] (Fig. 1). Additionally, it has been suggested that the supracondylar region undergoes remodeling at about