Supracondylar humerus fractures in adults

Background. Given the recent demographic changes, a significant increase of elderly patients with supracondylar humerus fractures is expected. Diagnosis. Due to the anatomical and biomechanical conditions at the distal humerus, these fractures require a detailed physical and radiological examination to determine the best possible treatment of the respective fracture type. The clinical examination should include special emphasis on the neurovascular status. Therapy. The aim of surgical treatment is to provided an exact and stable anatomical reconstruction and thus to allow early functional treatment to undermine long-term impairment. Therefore double plate osteosynthesis (small fragment reconstruction plate/angle-stable plate systems) and increasingly also implantation of total elbow prostheses in cases of very distal fractures and osteoporosis are the most common methods. During surgery, the ulnar nerve should be identified and protected intraoperatively. A conservative treatment approach to supracondylar humerus fractures in the elderly is only indicated for simple fractures or in case of absolute contraindications to surgery. The most frequent complications after distal humeral fractures are lesions of the ulnar nerve, heterotopic ossification and delayed or absent fracture healing.