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► In this short, we explore the supracondylar fracture, which is the most common elbow fracture in children. This type of fracture typically occurs as a result of a fall onto an outstretched arm, and it's crucial to identify it early to avoid complications.

The supracondylar fracture is often difficult to spot on initial X-rays, but certain features can help with diagnosis. In adults, the posterior fat pad sign—a clear indicator of a radial head fracture—is commonly observed, but in children, the supracondylar fracture is the most frequent cause of this finding. The presence of the fat pad behind the distal humerus can point to this type of injury, and this sign should raise concern for a fractured humerus.

Key diagnostic tools include:

Fat pad sign: This indicates that there is increased pressure in the joint due to a fracture. When seen in X-rays, it’s a strong indicator of elbow fractures.

Anterior humeral line: A line drawn along the anterior humerus should intersect the center of the capitellum in normal anatomy. If the line doesn’t pass through the center of the capitellum, it suggests that there’s displacement due to a fracture.

This video emphasizes how the fat pad sign and anterior humeral line can be used together to confirm the presence of a supracondylar fracture, even when the fracture itself isn’t immediately obvious on the X-ray. It's important to recognize these signs in pediatric patients, as timely intervention is crucial to prevent long-term complications such as malunion, restricted mobility, and growth disturbances in the elbow.

Understanding these key features will help you in diagnosing and managing pediatric elbow fractures, ensuring better outcomes for your patients.

► THE PROF 📚🏫
Dr. Hetal Verma is a Clinical Instructor of Radiology and the Co-Director of the Radiology Cambridge Integrated Clerkship at Harvard Medical School, MA, USA.
She is a graduate of the University of Massachusetts Medical School and completed her Breast Imaging fellowship at the Massachusetts General Hospital. Since 2012, she is the Director of Breast Imaging at Cambridge Health Alliance Radiology, a teaching affiliate of Harvard Medical School.
She is passionate about women's health and has vast experience in teaching medical students and residents at Harvard Medical School.

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