References
Prehospital management of paediatric supracondylar fractures
Abstract
Supracondylar humeral fractures are common in paediatric trauma. Prehospital management should focus on assessing and preserving the neurovascular integrity of the affected limb and on reducing pain. Secure immobilization and adequate analgesia are vital to achieving these aims. Currently, there is no consensus as to how to best immobilize the limb or to provide analgesia in the prehospital setting for a suspected supracondylar fracture. This article suggests an examination technique to assess the neurovascular status of the injured limb, and reviews some of the current methods of immobilization and analgesia used for prehospital management of supracondylar fractures.
Supracondylar humeral fractures account for approximately 60% of all fractures at the elbow, and up to 13% of all paediatric fractures overall (Omid et al, 2008). They occur most commonly between the ages of 5 and 8 years when the capsule and ligaments around the elbow have been shown to have greater tensile strength than the bone itself, which is weaker due to extensive remodelling that occurs at this age.
This results in an increased likelihood of fracture of the more vulnerable bone in the supracondylar region when force is applied across it (Beals, 1976; Lins et al, 1999; Ogden, 2000). They are very rare after 15 years of age, due to skeletal maturity, and occur more commonly in males than females (Beals, 1976; Lins et al, 1999).
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