1.Prepared by: Dr. Mostafa Azab Lecturer of Orthopedic Surgery Cairo University

2. Supracondylar Fracture of the Humerus Is a fracture, usually of the just abovehumerusdistal the , although it mayepicondyles occur elsewhere. While relatively rare in adults it is one of the most common fractures to occur in children and is often associated with the development of serious complications. 3. Classification: Flexion Type:20%Extension Type:80% 4. TYPES: There are three types based on the degree of separationof the fractured fragments: 1-Type I: undisplaced or minimally displaced fractures. 2-Type II: partially displaced. 3-Type III: fully displaced. 5. Epidemiology 1-This is the most common elbow fracture in children. 2-About 60% of fractures in children. 3-It is most common in children 2mm of displacement any joint incongruity Technique: Kocher lateral approach used avoid dissection of posterior aspect of lateral condyle (source of vascularization) intraoperative arthrograms are valuable to delineate the fracture and ensure anatomic reduction 18. Complications 1-Lateral overgrowth bump 2-AVN posterior dissection can result in lateral condyle osteonecrosis 3-Nonunion/malunion : caused from delay in diagnosis and improper treatment may result in cubitus valgus and tardy ulnar nerve palsy 19. Cubitus Valgus 20. Pulled Elbow(Nursemaids Elbow) Age: 1 to 4 yrs Elbow is pronated and flexed Painful movements 21. Reduction 22. OTHER INJURIES FREQUENCYINJURYELBOWPEDIATRIC REQUIRES ORPEAK AGE% ELBOW INJURIES FRACTURE TYPE Majority741%SUPRACONDYLA R FRACTURE Rare328%RADIAL HEAD Majority611%LATERAL CONDYLE Minority118%MEDIAL EPICONDYLE Minority105%RADIAL HEAD AND NECK # Rare135%ELBOW DISLOCATION Rare101%MEDIAL CONDYLE # 23. Distal Radial Injuries In Adults In Children 24. Salter Harris Classification I S = Slip (separated or straight across). Fracture of the cartilage of the physis (growth plate) II A = Above. The fracture lies above the physis, or Away from the joint. III L = Lower. The fracture is below the physis in the epiphysis. IV T = Through. The fracture is through the metaphysis, physis, and epiphysis. V R = Rammed (crushed). The physis has been crushed. 25. X-Rays 26. Complications: Growth Arrest & Deformity(Madlung Def.) 27. Principles of Treatment Anatomical Reduction Fixation by non-threaded wires Early mobilization 28. Anatomical Features 29. Colles Fracture Extra-articular fracture of the cancellous bone of the distal end of the Radius Displacement: 1-Shortening 2-Radial Deviation 3- Dorsal Angulation 30. Displacement 31. Mechanism of Injury Fall on the outstretched hand 32. Classification Type I: extra articular, undisplaced Type II: extra articular, displaced Type III intra articular, undisplaced Type IV: intra articular, displaced 33. Diagnosis -History -Pain -Swelling -Deformity -Loss of function -Neuro-vascular 34. Treatment Closed Reduction and casting 35. Treatment Closed Reduction and percutaneus pinning 36. Treatment External Fixation 37. Treatment Open Reduction & Internal Fixation 38. THANK U 39. Epiphyseal Injuries 40. THANK UU