FRCS Paediatric Ortho — improved notes
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120. Complications of supracondylar fracture

visual-inline rebuild0 extracted figuresspeaker notes XML37 study lines4 Q&A

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Clean FRCS notes with inline figures

Cubital varus deformity

•Incidence: 3% pinning vs 14% with casting

Etiology:

•Malreduction of supracondylar fracture
•Malunion of trochlear in lateral condyle fracture (type I fishtail)
•Trochlear AVN (type II fishtail deformity)
•Lateral overgrowth in lateral condyle fracture
•Neoplastic (exostosis)
•Skeletal dysplasia MED

Sequelae:

•Cosmesis most of the time
•Ulnar nerve palsy
•PL instability
•Deformity (varus, hyperextension, IR)
•Osteotomy

Timing: wait till skeletal maturity

•Lateral closing wedge osteotomy
•Uniplanar
•Step cut: more stable
•Right angled triangle (sup perpendicular to proximal shaft, inf: planned angle, lateral spike as step)
•Lag screw
•French
•Derotation
•Distal screw: lateral anterior. Proximal screw lateral posterior
•Tighten with figure of 8 loop
•Medial opening wedge osteotomy
•Dome osteotomy

Complications:

•Recurrence
•Nerve injury (displacement of radial nerve into osteotomy callus)
•Stiffness, infection, scarring
•Osteology of humerus
•Anterior tilt 30 degrees
•6 degrees valgus
•5 degrees IR
•Axis of rotation centered at trochlear and capitellum, passes through anteroinferior medial epicondyle

Direct Q&A

Q1 What diagnostic or radiographic findings support Complications of supracondylar fracture?

Cubital varus deformity

•Incidence: 3% pinning vs 14% with casting

Etiology:

•Malreduction of supracondylar fracture
•Malunion of trochlear in lateral condyle fracture (type I fishtail)
•Trochlear AVN (type II fishtail deformity)
•Lateral overgrowth in lateral condyle fracture
•Neoplastic (exostosis)
•Skeletal dysplasia MED

Sequelae:

Q2 What aetiology is described for Complications of supracondylar fracture?

Malreduction of supracondylar fracture

•Malunion of trochlear in lateral condyle fracture (type I fishtail)
•Trochlear AVN (type II fishtail deformity)
•Lateral overgrowth in lateral condyle fracture
•Neoplastic (exostosis)
•Skeletal dysplasia MED
Q3 What complications are listed for Complications of supracondylar fracture?

Recurrence

•Nerve injury (displacement of radial nerve into osteotomy callus)
•Stiffness, infection, scarring
Q4 How is Complications of supracondylar fracture managed?
•Incidence: 3% pinning vs 14% with casting

Etiology:

•Malreduction of supracondylar fracture
•Malunion of trochlear in lateral condyle fracture (type I fishtail)
•Trochlear AVN (type II fishtail deformity)
•Lateral overgrowth in lateral condyle fracture
•Neoplastic (exostosis)
•Skeletal dysplasia MED

Sequelae:

•Cosmesis most of the time
•Ulnar nerve palsy
•PL instability
•Deformity (varus, hyperextension, IR)
•Osteotomy

Timing: wait till skeletal maturity

•Lateral closing wedge osteotomy

Raw speaker-note hierarchy audit

#lvlmarLindentlogicaloriginal note line
10NoneNone0Cubital varus deformity
20NoneNone0Incidence: 3% pinning vs 14% with casting
30NoneNone0Etiology:
40171450-1714501Malreduction of supracondylar fracture
50171450-1714501Malunion of trochlear in lateral condyle fracture (type I fishtail)
60171450-1714501Trochlear AVN (type II fishtail deformity)
70171450-1714501Lateral overgrowth in lateral condyle fracture
80171450-1714501Neoplastic (exostosis)
90171450-1714501Skeletal dysplasia MED
100000Sequelae:
110171450-1714501Cosmesis most of the time
120171450-1714501Ulnar nerve palsy
130171450-1714501PL instability
140000Deformity (varus, hyperextension, IR)
150000Osteotomy
160000Timing: wait till skeletal maturity
170228600-2286001Lateral closing wedge osteotomy
181685800-2286002Uniplanar
1921143000-2286003Step cut: more stable
2021143000-2286003Right angled triangle (sup perpendicular to proximal shaft, inf: planned angle, lateral spike as step)
2121143000-2286003Lag screw
221685800-2286002French
2321143000-2286003Derotation
2421143000-2286003Distal screw: lateral anterior. Proximal screw lateral posterior
2521143000-2286003Tighten with figure of 8 loop
260228600-2286001Medial opening wedge osteotomy
270228600-2286001Dome osteotomy
280000Complications:
290171450-1714501Recurrence
300171450-1714501Nerve injury (displacement of radial nerve into osteotomy callus)
310171450-1714501Stiffness, infection, scarring
320000=======================
330000Osteology of humerus
340171450-1714501Anterior tilt 30 degrees
350171450-17145016 degrees valgus
360171450-17145015 degrees IR
370171450-1714501Axis of rotation centered at trochlear and capitellum, passes through anteroinferior medial epicondyle

Improved semantic hierarchy used for the study notes

#semantic levelsection?rewritten line
10Cubital varus deformity
21Incidence: 3% pinning vs 14% with casting
30yesEtiology:
41Malreduction of supracondylar fracture
51Malunion of trochlear in lateral condyle fracture (type I fishtail)
61Trochlear AVN (type II fishtail deformity)
71Lateral overgrowth in lateral condyle fracture
81Neoplastic (exostosis)
91Skeletal dysplasia MED
100yesSequelae:
111Cosmesis most of the time
121Ulnar nerve palsy
131PL instability
141Deformity (varus, hyperextension, IR)
151Osteotomy
160yesTiming: wait till skeletal maturity
171Lateral closing wedge osteotomy
182Uniplanar
193Step cut: more stable
203Right angled triangle (sup perpendicular to proximal shaft, inf: planned angle, lateral spike as step)
213Lag screw
222French
233Derotation
243Distal screw: lateral anterior. Proximal screw lateral posterior
253Tighten with figure of 8 loop
261Medial opening wedge osteotomy
271Dome osteotomy
280yesComplications:
291Recurrence
301Nerve injury (displacement of radial nerve into osteotomy callus)
311Stiffness, infection, scarring
320——
331Osteology of humerus
341Anterior tilt 30 degrees
3516 degrees valgus
3615 degrees IR
371Axis of rotation centered at trochlear and capitellum, passes through anteroinferior medial epicondyle
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