FREE AIIMS MCQ on 22 December 2016

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Question
Which of the following is true about supracondylar fracture of humerus?
A. Distal segment is dislocated anteriorly more than posterior
B. Nerve injury related manifestations are transitory
C. Injury causes weakness of elbow flexion
D. Cubitus valgus more common than cubitus varus during malunion

TIPSImportant Question from AIIMS 2013

Answer: B. Nerve injury related manifestations are transitory

Explanation :

Supracondylar Fracture of Humerus

  • Supracondylar fractures are the most common fractures in children <8 years old.
  • It occurs at the metaphyseal bone, proximal to the elbow joint, and does not involve the growth plate.
  • Distal segment is dislocated posteriorly more than anterior.
  • Cubitus varus more common than cubitus valgus during malunion.
  • Nerve injury related manifestations are transitory due to neuropraxia. Nerve injuries typically represent neuropraxis that resolve with observation over the subsequent 3–6 months. The most common cervical injury is pinching or stretching neuropraxia of the nerve root and brachial plexus. The injury is of short duration, and the patient has a full pain-free range of motion of the neck.
  • Weakness of elbow flexion is not seen in supracondylar fracture.
  • Displacement may be severe, and nerve injury, usually caused by stretching, is common.
  • If swelling is marked, there may be interruption of the blood supply; it is not uncommon for such a distal extremity to lack a pulse.

The most appropriate treatment is rapid anatomic reduction under general anesthesia. Because the reduction is highly unstable, many surgeons prefer to fix the fracture after reduction with percutaneous wires. On rare occasions, the surgeon must perform vascular or nerve exploration or repair.

Reference: Chapter 10. Pediatric Orthopedic Surgery. In: Skinner HB, McMahon PJ. eds. Current Diagnosis & Treatment in Orthopedics, 5e. Reference link ;  Orthopedic Surgery. In: Doherty GM. eds. CURRENT Diagnosis & Treatment: Surgery, 14e. Reference link .


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