Cutting edge Orthopedics

Supracondylar Humerus Fractures • 3  Fig. 2: Lateral view of a Gartland Type I fracture with cortical irregularity and fat pad sign best visualized posteriorly (Courtesy of Stephanie A. Russo, MD). Table 1: Radiographic findings, fracture characteristics, and typical management recommendations for each extension fracture type of the modified Gartland classification. Fracture type Radiographic findings Stability Treatment recommendations I Minimal displacement, AHL intersects center of capitellum Stable Immobilization in long arm cast for 3 weeks II IIa Posterior cortex intact, AHL anterior to capitellum Stable Closed reduction and pinning in most cases, some may be treated like Type I IIb Posterior cortex intact, rotational deformity, AHL anterior to capitellum Rotational instability Closed reduction and pinning III No cortical contact, AHL anterior to capitellum Unstable in extension Closed reduction and pinning IV Typically no cortical contact, AHL anterior or posterior to capitellum Unstable in flexion and extension Closed reduction and pinning AHL anterior humeral line Fig. 4.2 Lateral view of a Gartland Type I fracture with cortical irregularity and fat pad sign best visualized poste- riorly (Courtesy of Stephanie A. Russo, MD) Fig. 4.4 Lateral view of demonstrating an intact deformity (Courtesy of Jo 4 Supracondylar Humerus Fractures