Supracondylar fractures of the humerus in children.

Supracondylar fractures most commonly result in posterior and medial displacement of the distal fragment. The periosteum on the medial and posterior aspects of the humeral shaft is often intact. Closed reduction with immobilization by casting is preferred. Flexion of the elbow must be maintained in the cast. Internal fixation with percutaneous pins may be required, but only after satisfactory reduction. Olecranon skeletal traction is useful if ischemia develops. Neuropathies, ischemia and technical failures with angular deformities are not rare.