ZyraDoc #26 - August 27, 2026

A 6-year-old boy presents to the emergency department after falling onto an outstretched hand from a playground monkey bar with severe right elbow pain and deformity.

Radiographs reveal a completely displaced (Gartland Type III) extension supracondylar fracture of the distal humerus.

Physical examination demonstrates pale, cool fingers with a weak radial pulse, and the intern suggests applying a tight circumferential cast in extreme elbow flexion.

Case Summary

Clinical Focus:

A 6-year-old boy presents with a displaced (Gartland Type III) supracondylar distal humerus fracture with vascular compromise.

Diagnostic Features of Displaced Supracondylar Fractures:

Common pediatric elbow fracture mechanism: Fall on an outstretched hand (FOOSH)
Gartland Classification: Type I (undisplaced), Type II (displaced with intact posterior cortex), Type III (completely displaced)
Neurovascular vulnerability: High risk of injury to the median nerve (anterior interosseous branch), radial nerve, and brachial artery

Displaced pediatric supracondylar fractures are orthopedic emergencies requiring urgent surgical reduction and pinning; forced elbow flexion in casts must be avoided.

Here is the Management Strategy:

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